EPS with RF ablation Treatment Cost in India

The electroPhysiological study is the study or test that maps the electrical conduction system in the heart. Whereas Radiofrequency ablation is a nonsurgical procedure used to treat some types of rapid heart beating by eliminating areas of the heart that generate these abnormal heart rhythms causing the arrhythmia. But this treatment is usually adopted when there are corrections required for any abnormality found in the electrical system of the heart which can be confirmed in Electrophysiology studies or EPS. In the EPS process, abnormalities of the heart are noted. Medication and other ways will be explored to correct the problem first and then if required surgeon may decide to go with a cardiac ablation procedure.

During the ablation procedure of the heart, radiofrequency energy is used for the treatment of atrial flutter and supraventricular tachycardia and multifocal atrial tachycardia and ventricular arrhythmia.  Through the vein, the electrode which is placed on the tip of the catheter is placed in the heart. This special kind of catheter is referred to as an ablator. This process leads to the formation of scar tissue inside the heart which aids in keeping the heartbeat and rhythm normal.

EPS or cardiac ablation procedure is used for the rectification of heart rhythm troubles. In any individual, the heartbeats and electrical impulses that help to contract must follow a specific path along with the heart. Any interruption in receiving electrical impulses may cause abnormal heartbeat or arrhythmia that is further treated with the process of cardiac ablation.

But the above treatment is never the first option to be explored and should be done in the following conditions like:

• Medication has failed to provide relief
• Associated side effects for medication
• Specific arrhythmia trouble can be treated only with ablation, for example, Wolff-Parkinson-White syndrome and supraventricular tachycardia.
• Very high risk of complication from arrhythmia like a cardiac arrest

But also, there are risks that should be examined before the surgery.

Atrial fibrillation and flutter can be diagnosed in the following ways:

• Medical history
• Tests like Holter Monitor, ECG or Electrocardiogram, event recorder, Chest X-Ray, blood test, and stress tests may be conducted.
• Physical examination of symptoms like chest pain, dizziness, and confusion along with general fatigue.

The steps in the RFA procedure depends on the type of disorder that needs to be treated or the part of the body targeted.

The patient is shifted to the operating room where an IV or intravenous line is started in the vein of the arm to inject medications as may be required.  The patient is made to lie on the table and ECG leads are placed on the chest for the monitoring of the heart rhythm and rate.

Either groin, neck or arm is selected for the insertion of the catheter. This region is shaved and then antiseptic is dabbed and a local anesthetic may be employed for numbing the area. A small incision is made to insert the catheter in the vein. Some pressure can be felt during the procedure but unlike to experience any other discomfort.

With the help of X-Ray imaging and fluoroscopy, the catheter is made to progress and the doctor observes the motion in the monitor. Once the catheter reaches the heart, the electrical activities of the heart are recorded, and many parts of the electrical conduction system are further stimulated by the speeding of signal types.  Due to this process, patients are likely to experience dizziness, palpitations, and lightheadedness. Vital signs will be monitored all throughout the process and there will be medical staff who shall actively engage in light conversation with the patient. The patient is expected to experience some amount of arrhythmias and if there is any serious discomfort then that should be reported.

Through the IV line, various drugs can be injected to tackle arrhythmias and continuous evaluation is done for stopping the abnormality. Medications can also be changed if required to cater to different heart-related abnormality observed.

The above procedure does not take more than 20 minutes to an hour but along with this if the surgeon finds the need to conduct a radiofrequency ablation which is appropriate then it can be performed right after this.

During the RFA process or cardiac ablation surgery, the surgeon inserts a number of thin tubes having wires called electrode catheters through the sheath and they are made to access the heart.

A small electrical impulse is sent through the electrode catheter to locate the abnormal tissue that causes arrhythmia. This impulse activates the abnormal tissue and then the other catheters will detect the signal to exactly locate the abnormal site in the heart.

Now the catheter will be made to reach the exact abnormal site and a very mild but painless radiofrequency energy (equivalent to microwave heat) is transmitted to the tissue. This shall destroy the abnormal muscle of the heart (around 1/5 inch) which is causing the production of the extra impulses responsible for rapid heartbeats and any other irregularity.

This procedure does not take more than 2 to 4 hours and the process gets elongated when there are abnormal tissues in more than one location.

The energy sources used to destroy the scar tissue can be radiofrequency waves, lasers, microwaves or cryotherapy can be employed which works by freezing the tissue.

The patient can be released on that day itself or may be required to stay overnight.

Alternatives to RFA therapy is a less invasive and effective method for ventricular tachycardia specifically. This method is called epicardial catheter ablation, where a special catheter is produced in the pericardial space of the heart to pass through the chest wall. The tip is a cooled tip and then radiofrequency is used for heart tissue cauterization leading to an irregular rhythm.

Another technique called the Mini- Maze procedure is also used that provides an alternative to conventional catheter ablation for the purpose of atrial fibrillation. It works by interrupting the electrical pathways to the auricles of the heart and conversion of atrial fibrillation to a normal rhythm.

The surgery is minimally invasive and in particular areas of the heart, ablation produces a labyrinth of lesions. The surgical team uses radiofrequency jerks from between the ribs to cauterize the infected tissue. These cauterized zones are unable to conduct electrical impulses and transmit the abnormal stops of the signal, allowing the rest of the heart to beat regularly.

It is very important to understand the form of ailment one faces and to be persuaded that ablation with radiofrequency is the only treatment that will work in this situation. The patient must consider the complications arising from RFA such as heart valve injury, heart puncture, blood vessel damage or infection. The patient will discuss their medical history with their physician in depth so that they can be advised by the doctor with caution.

Right after the procedure, the patient is shifted to the recovery room for a few hours. One can expect some amount of numbness or type of weakness for some time which will diminish after a few hours. The patient is instructed to lie down for 3 to 4 hours without any movement.

Cardiac ablation costs in India can be in the range of $500 to $1000 only. Any kind of heart surgery is much cheaper in India compared to the UK and USA with the same quality treatment.