Radiofrequency Ablation of the Heart (RFA)

It is a minimally invasive treatment for heart rhythm disorders. Special catheters are passed to the heart through a vessel puncture. With them, the doctor identifies the areas of heart tissue involved in starting or sustaining the arrhythmia and applies radiofrequency energy to them.

Atrial fibrillation and flutter, supraventricular and some ventricular tachycardias, arrhythmias related to accessory pathways (including WPW syndrome) and some types of extrasystole. An arrhythmologist assesses individually whether RFA is possible.

The procedure is done under local anesthesia. Catheter electrodes are inserted through a small puncture in a vessel, an electrophysiological study and mapping are performed (with 3D navigation when needed), and radiofrequency energy is applied to the areas involved in starting or sustaining the arrhythmia.

The puncture site is numbed with local anesthesia, and there are no incisions. The physician discusses sensations during the procedure and pain relief with the patient in advance.

Usually an ECG at rest and during exercise, 24-hour Holter monitoring and echocardiography. An intracardiac electrophysiological study (EPS) may be performed before the ablation or during it to clarify the mechanism of the arrhythmia and identify the target areas.

It depends on the procedure and the patient’s condition; at our clinic it is usually 2–3 days. After discharge, most patients gradually return to normal activities within a few days.

Effectiveness depends on the type and mechanism of the arrhythmia, how long it has lasted and other conditions. For some types of tachycardia, ablation eliminates the mechanism of the arrhythmia with high probability. In atrial fibrillation recurrences are possible, and a repeat procedure is sometimes needed.

Yes, some patients, more often those with atrial fibrillation, may have a recurrence. In that case the physician may recommend a repeat ablation. That is why follow-up visits after the operation are important.

In RFA the heart tissue is treated with radiofrequency energy, in cryoablation with cold. Both are catheter methods. The choice depends on the type of arrhythmia and the arrhythmologist’s decision.

It depends on the type of arrhythmia and the results of treatment. After RFA the physician may continue, change or later stop antiarrhythmic medication. Do not stop treatment on your own. In atrial fibrillation, whether to continue anticoagulants is decided separately, taking into account the risk of thromboembolic complications.

Radiofrequency energy creates small, local areas of controlled tissue damage in the zones involved in starting or sustaining the arrhythmia. This is what changes the conduction of the electrical impulse and eliminates or suppresses the mechanism of the arrhythmia.

For the first few days, protect the puncture site and limit physical activity. Follow-up visits to a cardiologist are usually at 3, 6 and 12 months. Your physician will give individual recommendations.

At Pirogov Clinic the operation can be performed free of charge under CHI or a quota. Paid options start from 205,000 rubles.