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Supraventricular tachycardia, or SVT ablation, involves both non-surgical and surgical procedures to block abnormal electrical pathways that cause increased heart rates. Cardiac electrophysiologists generally do not perform the procedure unless the condition fails to respond to medication or treatment or the patient becomes physically disabled. Candidates for the procedure undergo ablation in a hospital setting, and non-surgical patients usually return home later in the day.
During a non-surgical SVT ablation, the patient receives a mild sedative and a local anesthetic to the insertion site. Using x-ray type imaging, an electrophysiologist threads wire-sized catheters through the major veins in the upper thighs, channeling the catheters up towards the heart. Through the catheters, the physician inserts the ablation wires, directing them toward the area of the heart that is producing the abnormal electrical pathway.
If tachycardia does not immediately occur, the physician may trigger the response using medication or other methods to target the exact location of the abnormality. After locating the problem area, a specially trained cardiologist uses cryothermy, lasers, microwaves, or radio waves transmitted along the ablation wire to burn tissues inside the pulmonary veins in designated locations. This impedes the abnormal impulses.
Once physicians believe that the tachycardia has been sufficiently eliminated, they remove the catheters and wires and apply a dressing to the insertion sites. The patient remains lying on his or her back in a monitored post-operative environment for four to eight hours, which allows the vessels ample time to close and begin healing. After the recommended time, the patient generally goes home and returns to normal activities within 48 hours. Patients frequently experience slight bruising and swelling at the insertion sites.
SVT ablation involving a modified surgical procedure requires making small incisions in the chest wall of an anesthetized patient. Through these incisions, the surgeon inserts an endoscopic camera and the instruments necessary to perform the ablation. The procedure requires no surgical removal of tissue but employs ablation wires similar to the instruments used in catheterization ablation. Using this method, surgeons can see the specific regions of the heart that are causing abnormal impulses and burn the heart tissue to inhibit tachycardia. The patient remains hospitalized for up to three days following the procedure.
A surgeon typically performs the open heart SVT ablation procedure when a patient requires bypass or valve repair in addition to tachycardia resolution. Under general anesthesia, the surgeon stops the heart and places the patient on a mechanical heart/lung machine. After completing the necessary cardiac repairs the surgeon restarts the heart. A cardiac surgeon might perform ablation by placing small cuts or snips in the heart tissue, which block abnormal pathways and correct heart rhythms. More often, the surgeon burns the tissue, which results in fewer complications. Hospitalization time after the surgery ranges from three to seven days.