October 12, 2024

What is an Ablation for VT?

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Understanding Ventricular Tachycardia (VT)

Ventricular tachycardia ablation, often referred to as VT ablation, is a procedure that uses heat or cold energy to create small scars within the heart tissue. These scars help block abnormal electrical signals that lead to an unusually fast and irregular heartbeat.

VT ablation is specifically used to treat a type of irregular heartbeat known as ventricular tachycardia, where the lower chambers of the heart, called the ventricles, beat at an excessively rapid rate. The primary aim of VT ablation is to restore and maintain a normal heart rhythm.

Treatment Options for VT

Here’s an overview of common treatment options for ventricular tachycardia, including medications and ablation:

Medications
- Antiarrhythmic Drugs: These medications help stabilize the heart’s electrical activity and prevent or reduce the occurrence of ventricular tachycardia episodes. Common antiarrhythmic drugs include amiodarone, sotalol, and mexiletine. These drugs work by slowing down the electrical impulses in the heart and are often used as a first line of treatment.
- Beta-Blockers: Beta-blockers, such as metoprolol, propranolol, and atenolol, reduce the effects of adrenaline on the heart. By decreasing the heart rate and the force of heartbeats, beta-blockers can help prevent rapid and irregular heart rhythms.
- Calcium Channel Blockers: Some calcium channel blockers, such as verapamil, can be used to manage certain forms of ventricular tachycardia. They work by slowing down the conduction of electrical signals in the heart and reducing heart rate.
Catheter Ablation
- Ventricular Tachycardia Ablation (VT Ablation): This procedure involves using a catheter to deliver energy (either heat or cold) to targeted areas of the heart muscle, creating small scars. These scars block the abnormal electrical pathways causing ventricular tachycardia. VT ablation is often recommended for patients who do not respond well to medications or those who experience frequent episodes of VT.
Implantable Cardioverter-Defibrillator (ICD)
- An ICD is a small device implanted under the skin, often near the collarbone, with wires connecting it to the heart. When it detects an abnormal heart rhythm, it can deliver an electric shock to restore a normal heartbeat. An ICD is typically recommended for patients at high risk of life-threatening arrhythmias.
Lifestyle Changes and Risk Factor Management
- For some patients, lifestyle changes can help reduce the frequency of ventricular tachycardia episodes. These changes include managing stress, avoiding stimulants (such as caffeine and tobacco), and treating underlying conditions like high blood pressure and sleep apnea.
Surgical Ablation (for Severe Cases)
- In rare cases, surgical ablation may be recommended if catheter ablation isn’t successful. This approach involves creating scars on the heart through open-heart surgery to block abnormal electrical signals.

Each of these treatment options may be used alone or in combination based on the patient’s specific condition, risk factors, and response to initial treatments.

How Are Ablation Procedures Performed?

Ventricular tachycardia (VT) ablation is a minimally invasive procedure aimed at correcting abnormal electrical pathways in the heart that cause a dangerously rapid heartbeat. Here’s a step-by-step breakdown of how VT ablation is typically performed:

1. Preparation for the Procedure

Pre-Procedure Assessment: Patients typically undergo diagnostic tests, such as an electrocardiogram (ECG), echocardiogram, and sometimes an electrophysiology (EP) study to map the heart’s electrical activity. Blood tests and imaging studies, like a cardiac MRI or CT scan, may also be performed to help plan the ablation.
Sedation and Anesthesia: The procedure is usually performed under local anesthesia and mild sedation, though general anesthesia may be used in some cases. The patient remains conscious but comfortable, allowing for monitoring and response during the procedure.

2. Catheter Insertion

Accessing the Heart: Small incisions are made, usually in the groin, to access a large blood vessel (typically the femoral vein or artery). In some cases, access points might include the neck or arm.
Catheter Placement: A thin, flexible catheter is then guided through the blood vessels toward the heart using real-time imaging (fluoroscopy) for precision. Multiple catheters may be used to monitor and stimulate different areas of the heart during the procedure.

3. Mapping the Heart’s Electrical Activity

Electrophysiology Mapping: Once the catheter reaches the heart, the electrophysiologist stimulates the heart tissue to provoke the VT. This allows them to pinpoint the exact location of abnormal electrical pathways. Advanced 3D mapping systems help create a detailed model of the heart’s electrical circuitry, enabling precise identification of the faulty areas.
Identifying the VT Focus: The specific areas in the ventricles responsible for the irregular rhythm are identified. This focus point is where the catheter will deliver energy to disrupt the abnormal pathway.

4. Ablation of Abnormal Tissue

Energy Delivery: Once the abnormal site is identified, the catheter delivers energy to that specific area. There are two main types of energy used for ablation:
- Radiofrequency Ablation (RFA): This method uses high-frequency electrical energy to generate heat and create tiny scars in the tissue, which disrupt the electrical signals causing VT.
- Cryoablation: In some cases, cryoablation (using cold energy) may be used instead. This method freezes the abnormal tissue to create the scar.
Confirmation: After delivering the energy, the electrophysiologist re-tests the area to ensure the abnormal signals are no longer present. They may repeat this process in multiple areas if needed to ensure complete resolution of the VT.

5. Post-Procedure Monitoring

Catheter Removal and Incision Care: The catheter is removed, and pressure is applied to the access site to prevent bleeding. A small bandage is placed over the insertion area.
Observation and Recovery: The patient is monitored for a few hours to ensure there are no immediate complications, such as bleeding, infection, or arrhythmias. A hospital stay of one night may be recommended, depending on the patient’s response to the procedure.
Follow-Up: Patients are typically advised to avoid strenuous activity for a short period and may be prescribed medication temporarily to prevent inflammation or arrhythmias as the heart heals.

6. Expected Outcomes and Recovery

Effectiveness: VT ablation has a high success rate, particularly for patients with well-defined VT triggers. However, multiple procedures may be needed for some patients to achieve optimal results.
Risk of Recurrence: While ablation is highly effective, some patients may experience a recurrence of VT over time. In such cases, additional ablation procedures or alternative therapies (e.g., medications or ICD placement) may be considered.

As of 2024 I have personally gone through three VT ablation procedures. I typically find that I feel better after the procedure but obviously with three procedures there are no long term guarantees that you may not become a candidate again. VT ablation is generally safe, but as with any procedure, it carries some risks. These may include bleeding, infection, blood clots, or damage to blood vessels or the heart. However, for many patients, VT ablation significantly reduces the frequency of ventricular tachycardia episodes and improves quality of life.

*WARNING: Remember to always consult with your doctor before starting any nutrition or exercise program to ensure the program is right for you.

Dr. Angela M. Sterling, D.C. is a chiropractor in Blue Springs, Missouri. She has a passion for helping others that has led her down the path of Alternative Medicine into a career that allows her to provide patients with high quality health care. As a licensed Chiropractic Physician, she brings a holistic approach to medicine in order to find comfortable and effective solutions for everyone. Dr. Sterling is a Nationally Board Certified Doctor of Chiropractic and Nationally Board Certified in Physiotherapy.

You can contact Dr. Angela Sterling by phone or text at (816) 425-0888 or via email at Angela.Sterling@chiroone.net.

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