What Is A Heart Ablation and How Catheter Ablation Corrects Heart Rhythm

Heart ablation is the term used by cardiac specialists for the treatment of cardiac arrhythmias in which they deliberately obliterate pathological areas of the heart muscle tissue

Catheter ablation can permanently repair certain forms of cardiac arrhythmias. Beginnings of this treatment method exist since the eighties. Since then, technology has made tremendous progress. Today, numerous cardiology departments perform the procedure.

How does a catheter ablation work?

Understanding the principle of catheter ablation requires some basic knowledge of how the heart works: the heart consists of four heart cavities, two atria and two main chambers. The beating of the heart is generated by electrical impulses that arise at a specific location in the right atrium. From this so-called sinus node, the electrical impulses spread over the atria and the atrioventricular node (AV node) on the heart chambers and cause the contraction of the heart muscle (conduction system see also graph).

If there are additional faulty pathways or sites in the myocardial tissue that trigger further excitement, there will be episodic or persistent irregular heartbeat. This can be treated by the so-called catheter ablation. Depending on the cause of the disease, the doctors either devour the starting point of the additional heart beats or the abnormal pathways.

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When will a catheter ablation be used?

For most forms of cardiac arrhythmia, the doctor will first try to treat them with medication. If this therapy fails, catheter ablation can permanently rid the patient of his symptoms in certain types of arrhythmia:

In Wolff-Parkinson-White syndrome (WPW syndrome), there is a congenital pathway between the atria and the ventricles as a short circuit. About the short-circuit connection, the excitement reach the chambers prematurely. It comes to the attacking tachycardia. After catheter ablation, when the expert obliterates the extra pathway, cardiac arrhythmia has disappeared in over 95 percent of cases.

In AV node reentry tachycardia, the electrical impulses circulate in the AV node. This causes tachycardia. Catheter ablation is the treatment of choice for this common cardiac arrhythmia and is successful in more than 95 percent of cases.

In atrial tachycardia (“atrial tachycardia”), the electrical impulses do not emanate from the sinus node but from other locations in the right atrium. The chances of a successful catheter ablation are slightly lower in atrial tachycardia than in WPW syndrome and AV node reentry tachycardia.

In typical atrial flutter, there is also a circular excitement in the right atrium. As the cardiac arrhythmia can be permanently cured by the catheter ablation in 95 percent of cases, it is clearly superior to the drug therapy.

Atrial fibrillation can be caused by electrical impulses from the pulmonary veins. When atrial fibrillation causes discomfort such as shortness of breath or heart failure, doctors use catheter ablation to electrically isolate the pulmonary veins. As a result, the interfering impulses should no longer reach the forecourts. The procedure lasts several hours. So far, he has been successful in seizure-related atrial fibrillation in about 70 percent of cases. For chronic atrial fibrillation, the success rate is just over 50 percent. Therefore, catheter ablation is only used when medications can not normalize the heart rhythm. Often, the patient must continue to take medication after ablation. In some cases, the catheter ablation needs to be repeated.

Although isolation of the pulmonary veins is not possible, there is still the possibility of AV node ablation. By sclerosing the AV node, the atria and chambers of the heart are completely separated electrically. The patient then needs a pacemaker. Therefore, AV node ablation is only an emergency solution.

How does a catheter ablation work?

Catheter ablation is usually performed as part of an electrophysiological examination (EPU) in the hospital. The standard procedure is radiofrequency ablation. Their principle is that the catheter tip delivers heat to the tissue with pinpoint accuracy. Other ablation procedures work with cold (cryoablation).

The inpatient admission usually takes place the day before the procedure so that the medical history can be recorded, the reconnaissance interview conducted and necessary preliminary examinations can be made.

Catheter ablation is performed like a cardiac catheter or EPU under local anesthesia. The patient is conscious. If necessary, the doctor administers painkillers and sedatives. First, the doctor examines exactly the cardiac arrhythmias and their place of origin in the EPU. Then he sets in the heart tissue on the ablation catheter targeted small scars of a few millimeters, to prevent the emergence or transmission of cardiac arrhythmia. After the sclerotherapy, if necessary, the doctor tests whether the cardiac arrhythmia can still be triggered by electrical impulses.

The duration of the procedure is very variable and can hardly be predicted. It can take two to six hours or, in some cases, even longer. The procedure after the procedure is similar to the follow-up treatment with the EPU: The doctor removes the catheters from the heart. In order to prevent rebleeding, he supplies the puncture site with a pressure dressing, which should remain there for 6 to 12 hours. During this time, the patient must observe strict bed rest so that the dressing does not slip. Mostly he can go back to work after a few days.

What are the risks and side effects of catheter ablation?

In most cases, the procedure is without complications. The complications that can occur with catheter ablation are essentially the same as those of the EPU. The doctor discusses it with the patient in a consultation before the examination.

Symptoms and Diagnosis of Stage 4 Lung Cancer

To assist physicians in deciding what type of treatment is more appropriate for lung cancer, there is a recognized numerical staging system that creates benchmarks. At Stage I, the cancer is small and localized in a specific area of ​​the lung. During phases 2 and 3, the cancer grows and spreads to the surrounding tissue and possibly the lymph nodes.

Stage 4 lung cancer is when the cancer has spread, or metastised, from the lungs to other parts of the body. Typically, the cancer spreads to the liver, bones, brain or adrenal glands. This is commonly known as secondary or advanced cancer. About 40% of lung cancer patients are diagnosed at stage 4, mainly because the symptoms of lung cancer could include symptoms of other diseases. In Stage 4, the cancer is not curable, but it can be treated. These are some of the symptoms that may help your doctor to diagnose stage 4 lung cancer.

Breathing problems

Lung cancer patients often present with shortness of breath, wheezing and hoarseness. It is often a persistent cough, and the patient can cough up blood. Sometimes, a chronic cough that the patient may suddenly change for some time may be natural. Because these symptoms may also affect other conditions, they are not sufficient to suggest a diagnosis of lung cancer. However, if a smoker presents with these symptoms, a diagnosis of stage 4 lung cancer is likely to be considered by the doctor.

Pain

Patients may experience pain in various areas of the upper body, including the back, chest, arms, ribs and hips. Deep breathing often intensifies the pain that can be felt in the tissues or bones depending on the spread of the cancer. It can also be pain when swallowing. Some people suffer from frequent headaches, which is an indication that the cancer could be affecting the brain.

Weight Loss

With stage 4 lung cancer, there is often a sudden, unexplained weight loss that is often accompanied by loss of appetite and a general feeling of weakness and fatigue. If this weight loss is significant and you do not have a diet, it should be investigated.

“Clubbing”

The nails on the fingers and toes can bulge, and the ends of the fingers change shape. This symptom usually develops in the latter stages of lung cancer, so it is a good indicator of diagnosis.

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Diagnosis

The diagnostic process for stage 4 lung cancer is usually some form of imaging, such as computed tomography (CAT) or magnetic resonance imaging (MRI). These scans give a detailed picture of the spread of the cancer as X-rays, allowing the doctor to determine the cancerous stage. A radionuclide scan can detect if the cancer has spread to other organs, while a bone scan will show if the bones are affected.

The doctor may also conduct tests to determine if the cancer has spread to the lymph nodes. This involves removing a tissue sample for testing under general anesthesia. This process is called medias or mediastinotomy, depending on whether the tissue is absorbed by the neck or the chest.

While all these symptoms refer to other conditions, if you experience one or more of them for two weeks or more, you should consult your doctor. Lung cancer is particularly dangerous because it metastises to other parts of the body relatively quickly, making it one of the most life-threatening cancers there is. As with most conditions, the earlier the diagnosis, the more likely that the treatment will succeed. During treatment for stage 4 lung cancer, the condition will not heal, it can prolong life and improve quality of life, so it is important to seek medical advice as soon as possible.

What are The Symptoms Of Lungs Cancer, Treatment & Prognosis

Lung cancer is a malignant neoplasm in the respiratory system (lungs and bronchi). In addition to breast cancer, colon cancer and prostate cancer, it is one of the most common cancers worldwide. Unfortunately, the number of illnesses continues to increase, especially among women.

Short version:

    • Smoking causes 85% of lung cancers.
    • Lung cancer is caused by a change in the genetic material due to chronic damage.
    • Lung carcinomas can be divided into two groups.
    • Because symptoms are unrecognized or misinterpreted, lung cancer is often discovered by accident during examinations.
    • The treatment of a lung tumor depends on the type of cancer.

In Austria, around 2,500 men and almost 1,200 women suffer from bronchial carcinoma each year. Thus lung cancer is second only to prostate cancer in males and third in women after breast and colon cancer. Most cases are detected between the 55th and the 65th year of life. However, patients can be significantly younger.

The main risk factor for the development of lung cancer is cigarette smoking: Around 85% of all cases can be attributed to tobacco consumption. Hereditary predispositions or contact with other harmful substances (such as arsenic, radon or asbestos), on the other hand, play a subordinate role. 3-5% of the diseases are caused by passive smoking.

From surgery to Targeted Therapy: Depending on the type and stage, lung cancer is treated differently.

Anyone smoking a pack of cigarettes every day for over 20 years increases their lung cancer risk 30 to 40 times. By contrast, a familial accumulation only leads to a doubling or tripling of the risk.

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How does lung cancer develop?

In the cells of the mucous membranes of the bronchi and in the alveoli, there is a change in the genetic material due to prolonged chronic damage (for example, chronic inflammation from cigarette smoke). After a long time, this change means that the normal control mechanisms for the growth and death of cells are no longer effective and a malignant tumor develops. At an early stage of development, this process can sometimes be reversed, such as when the damaging effects are stopped.

Basically, two groups of lung cancer are differentiated:

    1. Non-small cell lung carcinoma

The non-small cell type accounts for around three quarters of cancers of the lung. It is roughly subdivided into:

    • squamous cell carcinoma
    • the adenocarcinoma
    • the large cell carcinoma
    1. Small cell lung carcinoma

Small cell lung cancer (about 20% of the disease) spreads rapidly through the bloodstream and lymphatics, but is better for chemotherapy.

This distinction is important from a medical point of view, because the therapy is targeted accordingly.

Which symptoms occur?

In those cases of lung cancer that are discovered at an early stage, these are generally incidental findings: pulmonary x-raying is actually done for quite different reasons, e.g. in case of release for surgical procedures or severe infections suggesting pneumonia.

The most significant problem is that the disease remains asymptomatic for a long time. Often, the typical symptoms, such as coughing, shortness of breath, fatigue or back pain, misinterpreted or ignored. Since the majority of sufferers are smokers with chronic bronchitis and often have cardiovascular problems, the symptoms are attributed to them.

A doctor’s visit is therefore often delayed for a long time. Only the appearance of blood in the sputum or severe weight loss are alarming. More than two-thirds of all cases of lung cancer are therefore diagnosed at a local or systemic (i.e., distant metastasis) stage.

Unfortunately, previous large-scale studies on the possibility of early diagnosis have not shown sufficiently satisfactory results to be meaningful to broad sections of the population. A so-called spiral computed tomography (spiral CT) with low radiation dose is therefore recommended as a preventive check only certain risk groups: chronic smokers over 50 years, especially if at the same time a chronic obstructive pulmonary disease (COPD) is present; in addition, in the case of lung cancer in the family or a workplace that is burdened by inhaled carcinogens (carcinogenic substances). However, the last two factors only seem relevant if the person smokes himself at the same time.

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How does the doctor make a diagnosis?

If lung cancer is suspected, the patient is referred to a specialized department where a complete examination is made as soon as possible. Among other things, the stage of the disease, the type of tumor and the spread in the body is examined.

For this purpose, different examination methods such as computed tomography, ultrasound, biopsy or a PET scan are performed.

Which treatment methods are available?

The choice of treatment for lung cancer depends largely on the type of cancer and the stage of the cancer.

Treatment options range from surgery to radiation and chemotherapy, to molecular biology therapy.

What is the prognosis for lung cancer?

In contrast to other types of cancer, in the case of bronchial carcinoma, there are no meaningful early detection measures or long-term successful treatment methods. Lung cancer is the only cancer in which the rate of new disease is nearly identical to that of deaths.

Taking all the cases together, current treatment methods achieve a 5-year survival rate of only 15%. However, when early-stage non-small cell lung cancer is detected, around 75 out of every 100 people treated surgically are still alive five years later.

At the same time, lung cancer is virtually the only cancer that has a prevalent and avoidable risk factor. Prevention through smoking cessation is therefore at the forefront.

Especially in the case of lung cancer, it must be emphasized how important it is to participate in the clinical trials offered, as it provides access to new drugs that are not yet on the market, and one can expect further improvements. Moreover, it is only possible to further advance the progress in the treatment of this problematic disease.

As regards therapy, great progress has been made in all areas in recent years. It has become much better in terms of effectiveness and tolerability. This leads to an improvement in quality of life, lifespan and a reduction in side effects.

What can i do on my own?

If you are a smoker, stop as soon as possible!

There are studies showing that certain drugs used to treat lung cancer are less effective when smoked during treatment. The effect of radiation therapy is also disturbed, and surgery increases the rate of complications.

In addition, it is known that patients who have undergone successful surgery have a higher risk of developing another lung cancer if they continue to consume nicotine than those who have quit smoking.

In addition, of course, all health care measures are also useful in the case of this disease: such as vitamin and fiber rich diet with restriction of sugar and fat content and sufficient exercise in the fresh air.