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surgical removal of a body part or tissue (同)extirpation, cutting out, excision
the erosive process that reduces the size of glaciers
a thin flexible tube inserted into the body to permit introduction or withdrawal of fluids or to keep the passageway open

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切除,除去;融除 / 溶発(ロケットの先端が大気圏突入で溶解すること)
カテーテル,(特に)導尿管(体内液の排出・導入に用いる細い管)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/02 18:45:23」(JST)

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Catheter ablation is an invasive procedure used to remove or terminate a faulty electrical pathway from sections of the hearts of those who are prone to developing cardiac arrhythmias such as atrial fibrillation, atrial flutter, supraventricular tachycardias (SVT) and Wolff-Parkinson-White syndrome.

Indications[edit]

Catheter ablation may be recommended for an arrhythmia that medicine can't control. The patient has faulty electrical activity in the heart that increases their risk of ventricular fibrillation and sudden cardiac arrest. Ventricular fibrillation is a life-threatening arrhythmia. Sudden cardiac arrest is a condition in which the heart suddenly stops beating.

Technique[edit]

Catheter ablation involves advancing several flexible catheters into the patient's blood vessels, usually either in the femoral vein, internal jugular vein, or subclavian vein. The catheters are then advanced towards the heart. Electrical impulses are then used to induce the arrhythmia and local heating or freezing is used to ablate (destroy) the abnormal tissue that is causing it. Newer procedures allow for the terminating of diseased or dying tissue to alleviate the chance of arrhythmia.

Catheter ablation is usually performed by an electrophysiologist (a specially trained cardiologist) in a cath lab or a specialized EP lab.

Prognosis[edit]

Catheter ablation of most arrhythmias has an extremely high success rate.^{[citation needed]} Success rates for WPW syndrome have been as high as 95% ^[1] For SVT and atrial flutter, the success rates are 95-98%.^{[citation needed]} For automatic atrial tachycardias, the success rates are 70-90%.^{[citation needed]} The potential complications include bleeding, blood clots, pericardial tamponade, and heart block, but these risks are very low, ranging from 0.5-3%.^{[citation needed]}

For atrial fibrillation, several experienced teams of electrophysiologists in US heart centers claim they can achieve up to a 75% success rate. However one recent study claims that the success rates are in fact much lower. Single procedure success rates have been published in this study at 28%. Often, several procedures are needed to raise the success rate to the 70-80% range. ^[2] One reason for this may be that once the heart has undergone atrial remodeling as in the case of chronic atrial fibrillation sufferers, largely 50 and older it is much more difficult to correct the 'bad' electrical pathways. Young AF sufferers with paroxysmal, or intermittent AF, therefore have an increased chance of success with an ablation since their heart has not undergone atrial remodeling yet.

Risks and complications[edit]

Risks of catheter ablation for atrial fibrillation include, but are not limited to: stroke, esophageal injury and death. Catheter ablation involves radiation. Radiation from the procedure may increase the risk of cancer, although the risk is small.

Recovery or Rehabilitation[edit]

After catheter ablation the person is moved to a cardiac recovery unit or cardiovascular intensive care unit where the person who had the procedure is not allowed to move for 4-6 hours. Minimizing moving helps prevent bleeding from the place the catheter was inserted into the body. Some people have to stay overnight for observation and some need to stay much longer. However, most people are able to go home the same day.

References[edit]

^ Thakur, R. K., Klein, G. J., & Yee, R. (1994). Radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome. CMAJ, 151(6), 771-776.
^ Cheema, et al. Long-term single procedure efficacy of catheter ablation of atrial fibrillation. J Interv Card Electrophysiol (2006) 15:145-155.

External links[edit]

The Arrhythmia Alliance UK

The Heart Rhythm Society

UpToDate Contents

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English Journal

Catheter ablation of atrial fibrillation in Chinese elderly patients.

Liu Y, Huang H, Huang C, Zhang S, Ma C, Liu X, Yang Y, Cao K, Wu S, Wang F; National Atrial Fibrillation Working Group of Chinese Society of Pacing and Electrophysiology.SourceDepartment of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
International journal of cardiology.Int J Cardiol.2011 Oct 20;152(2):266-7. Epub 2011 Aug 23.
PMID 21864920

Value of Real-Time Transesophageal 3-Dimensional Echocardiography in Guiding Ablation of Isthmus-Dependent Atrial Flutter and Pulmonary Vein Isolation.

Faletra FF, Regoli F, Acena M, Auricchio A.SourceDivision of Cardiology, Fondazione Cardiocentro Ticino.
Circulation journal : official journal of the Japanese Circulation Society.Circ J.2011 Oct 6. [Epub ahead of print]
In the past decade, both the range of indications and the efficacy and safety of interventional electrophysiology has improved considerably. This progress is attributed to both the accumulating experience of electrophysiologists and the advances in technological tools facilitating the diagnosis and
PMID 21979147

Japanese Journal

Rhythm Control Should Be Better for the Management of Patients With Atrial Fibrillation and Heart Failure : Rhythm Control vs. Rate Control : Which Is Better in the Management of Atrial Fibrillation? (Rhythm-Side)

KURITA Takashi,MOTOKI Koichiro,YASUOKA Ryobun,HIROTA Takayoshi,AKAIWA Yuzuru,KOTAKE Yasuhito,MIYAZAKI Shunichi
Circulation journal : official journal of the Japanese Circulation Society 75(4), 979-985, 2011-03-25
NAID 10028103690

Rate Control Is a Better Initial Treatment for Patients With Atrial Fibrillation and Heart Failure : Rhythm Control vs. Rate Control : Which Is Better in the Management of Atrial Fibrillation? (Rate-Side)