Catheter ablation for cardiac arrhythmias

Ablation is the safe and curative treatment of choice

The first diagnostic electrocardiography on a person was carried out by Augustus Waller over a century ago at St Mary's Hospital, London. It was not until the 1980s that therapeutic cardiac electrophysiology emerged; this procedure, carried out while patients are conscious, uses wires passed percutaneously to the heart to ablate the cause of arrhythmias. Cardiac electrophysiology is now an established specialty within cardiology. 1 2 Although the word “cure” is not widely applicable in medicine, it can now justifiably be used for the treatment of cardiac arrhythmias. Catheter ablation is a safe and curative option for most arrhythmias, with 85-98% cure rates among the arrhythmias treated most frequently. 3 4 These results have been borne out by a recent large prospective multicentre study of 1050 patients which provides further evidence of the benefit of catheter ablation; the study found an overall cure rate of 95% and that a second procedure was required in 4% of patients. The rate of important complications related to the procedure was <3%.3 The only randomised trial comparing catheter ablation with drugs in the treatment of recurrent atrial flutter showed that ablation had a better success rate, a greater impact on …