2023-06-13 01:14:27
Dr. Helder Hernández issues his medical opinion on the ablation procedure in patients suffering from the heart.
By: isbelia farias
Cardiac ablation is a procedure that scars the heart tissue to block irregular electrical signals. Dr. Helder Hernández practices regarding 100 or 150 ablations a year, a number that in his opinion is high. However, some pre-existing conditions or high life expectancy may be factors that affect the fact that a patient ends up requiring this type of procedure.
In an exclusive interview for the Journal of Medicine and Public Health, Dr. Helder Hernández, electrophysiologist, shares his knowledge regarding epicardial ablation of ventricular tachycardia and indicates that the first ablations that were done were through open heart surgery. “The doctors entered the operating room with the patients, who suffered from arrhythmias, whether ventricular or atrial, and through a typical open-heart surgery they either resected the tissue where the arrhythmia was formed or performed direct ablation, with the heart facing to them, through catheters that emit radiofrequency, or cryoablation, which is with cold”, he points out.
This was an invasive procedure that represented a high mortality risk for patients, but this evolved to procedures that were very similar to catheterization. “Today we perform these procedures with catheters through the groin, through the veins or arteries of the groin, and we reach the heart and the lesions are created, but in a much less invasive way, to the point that on many occasions the patient leaves home the same day,” says Dr. Hernández.
The most widely used energy source is radiofrequency, which consists of the emission of heat from the tip of the ablation catheter to a patch worn by the patient. Said heat results in a scar in the tissue in which the circuit is formed. of arrhythmia and when the scar forms, that tissue is not capable of transferring electric current, so the condition is cured to the patient.
The success of the procedure will depend on the type of arrhythmia. In the case of ventricular arrhythmias, the success rate is 95%; When it comes to atrial fibrillation, in patients over 65 years of age, with obesity, it is not curative, but the arrhythmia can be controlled and the patient can be stable for a couple of years. Ventricular, or lower chamber, heart arrhythmias are a bit more difficult to treat and the success rate tends to be a bit lower, around 70-80%. If the patient has a previous heart attack, or has a pacemaker, the success rate is 50%.
success of cardiac ablations
It all depends on the age of the patient, the type of arrhythmia and the location of the arrhythmia. When they are from the upper chamber, the rate is higher than when it comes to the lower chambers. In young patients, with supraventricular arrhythmias, they develop them because electrical impulses are generated by tissues through which they are not supposed to pass, such as accessory pathways. It is similar to going on a highway, but to go faster, you take an alternate route.
There are patients with a structural disease, due to a heart attack, these patients, the arrhythmia is produced by the scars that arise with the heart attack, these scars contain living tissue within the scar and this allows arrhythmias to form from the entrance, or ventricular tachycardias, that is why sudden death occurs. These patients should be fitted with a defibrillator, because it is the only thing that has been shown to be life-saving in these cases.
The heart is the only organ that can generate an electrical impulse spontaneously, that is, in the absence of an external stimulus. The same organ generates it, from the autonomic or involuntary nervous system, but this electrical system can fail and give way to heart arrhythmias.
when they are done ablations, using heat or cold, the purpose is to create a scar area that serves as a blockage, which works as a mesh so that the electrical impulse does not pass through there, because scar tissue does not conduct electricity. This will not affect the functioning of the heart because it is not an essential area for the heart to continue working.
Some ablations they must be practiced carefully because they have their risks, for which multiple equipment and technology are used to graphically visualize exactly where it is located and that complications do not arise and that the patient ends up with a pacemaker, near a coronary artery and that it occurs a heart attack, or other damage. Although it is a procedure that has evolved, it has its risks and therefore specialists receive rigorous training.
Currently, there are 16 electrophysiologists in Puerto Rico, which is a low number given that heart disease is the most common. Obese, diabetic, and hypertensive patients, among others, may suffer from cardiac arrhythmias and end up receiving an ablation. “I came to stay and we have a lot of work,” confirms Dr. Hernández, who feels committed to the service he provides to the country.
You can see the interview with the expert in more detail: here
1686658256
#heart #organ #spontaneously #generates #electricity #Helder #Hernández
