What Are the Most Common Complications of Cardiac Catheterization?

Cardiac radiofrequency ablation is an interventional method for tachyarrhythmia, which has been used for more than 20 years. A very thin catheter is placed into the blood vessel from the neck and thigh roots, and when it reaches the heart disease site, it releases radio frequency current, thereby eliminating the "lesion" at one time. This method does not require surgery, has minimal trauma, and has a very high success rate. It has become the preferred method for radical tachyarrhythmia.

Cardiac radiofrequency ablation

Cardiac radiofrequency ablation (catheterradiofrequency ablation) is to send an electrode catheter through a vein or arterial blood vessel to a specific part of the heart cavity, releasing radiofrequency current to cause local endocardial and subendocardial coagulative necrosis, achieving rapid block

Arrhythmia refers to abnormal changes in the normal rhythm of the heart, and arrhythmias faster than normal heart rate (60-100 beats / min) are called tachyarrhythmias, and paroxysmal supraventricular tachycardia, Atrial tachycardia, idiopathic ventricular tachycardia, and pre-excitation syndrome are clinically characterized by palpitations, palpitation, chest tightness, fatigue, dizziness, and dizziness. In severe cases, chest pain, dyspnea, cold sweating in the limbs, loss of consciousness, and convulsions And other performance.

I. Atrioventricular reentrant tachycardia (pre-excitation syndrome): There is a congenital bypass between the atrioventricles, and the radiofrequency of the catheter will cut off the bypass, and tachycardia or pre-excitation will no longer exist.

Atrioventricular node reentrant tachycardia: the atrioventricular node forms a "double path", and the current runs quickly in the reentrant loop formed by the two paths under appropriate conditions, causing tachycardia; the catheter RF ablation slows down and only retains Fast track, tachycardia is no longer ready for seizures.

Atrial flutter (atrial flutter):

Children have the characteristics of thin blood vessels, small heart, etc. The implementation of radiofrequency ablation is difficult and risky, and it needs to be carefully selected. For children with tachyarrhythmia under 3 years of age, try to take medication as much as possible. Radiofrequency ablation surgery can be considered for patients over 3 years of age. For arrhythmias such as premature beats, the drug cannot shorten the course of the disease, but only relieves the symptoms. Drug treatment should be highly vigilant for its toxic and side effects; only when the tachycardia affects the child's quality of life and physical development, anti-arrhythmic drugs are actively used, suitable for the situation Radiofrequency ablation is used.

1. Electrophysiological examination and radiofrequency ablation generally require hospitalization, and require routine laboratory tests (including electrocardiogram and blood tests, etc.).
Second, dietary precautions: Do not eat or drink 6-8 hours before surgery.
3. Tell the doctor the name and dosage of the medicine used. All antiarrhythmic drugs should be stopped 3-5 days before the electrophysiological examination and radiofrequency ablation. The antiarrhythmic drugs may affect the test results.
4. Tell your doctor about allergies to the drug.

Electrophysiology and radiofrequency ablation are performed in a special operating room (called a catheterization room). Catheter room staff typically includes electrophysiologists, assistants, nurses, and technicians. The patient is lying on the X-ray examination bed. The medical staff will connect various monitoring devices to the patient's body and cover your body with a sterile sheet. The medical staff will wear a sterile surgical gown and gloves.
First the skin of the catheter insertion site (inguinal, arm, shoulder or neck) is disinfected, and local anesthesia is used for local anesthesia; then the vein / arterial blood vessel is punctured with a puncture needle, and the electrophysiological examination catheter is inserted into the heart cavity through the blood vessel; The electrode catheter is a long, bendable catheter that can carry electrical signals to and from the heart. The electrode catheter records the electrical activity of different parts of the heart and issues weak electrical stimuli to stimulate the heart in order to induce arrhythmia and clear the diagnosis of tachycardia; then the doctor finds the exact part of the heart's abnormal electrical activity through the catheter (this process is called "standard Measurement "), and then send RF current ablation treatment through the ablation device, so as to cure tachycardia.

The patient is generally awake during the whole process. Sometimes the doctor will use sedatives to relieve the tension of the patient, and the patient will monitor the whole process. The electrophysiological examination generally does not cause pain, and the patient will not feel when the catheter is in the blood vessel and the heart cavity. The doctor may The heart will be stimulated with a weak current. The patient will not feel these electrical pulses, which will often induce tachycardia. It will feel the same as before (he may have dizziness, dizziness, palpitations, chest pain, or shortness of breath, etc.). Tell the doctor. ; These operations are relatively low risk and relatively safe.

Atrial arrhythmias such as atrioventricular node reentrant tachycardia, pre-excitation syndrome and other arrhythmias can achieve a success rate of more than 98%, while atrial tachycardia, atrial flutter, early ventricular, idiopathic ventricular tachycardia and other complex arrhythmias can achieve successful rates More than 90%, the current ablation success rate of atrial fibrillation is 80 to 90% for paroxysmal atrial fibrillation, and 60 to 80% for persistent and chronic atrial fibrillation. The success rate of reablation will be further improved.

Complications of vascular puncture include local bleeding, hematoma, infection, pneumothorax, thrombosis, embolism, etc. Complications of catheter operation include aortic valve regurgitation, myocardial perforation, pericardial tamponade, etc. Complications of discharge ablation include atrioventricular block, myocardium Infarction, etc.

After radiofrequency ablation, the patient must stay in bed and rest according to the doctor's advice. The sandbag at the venipuncture point is compressed for 6 hours, the sandbag at the arterial puncture area is compressed for 8-12 hours, and the affected limb is braked (restricted). Watch for bleeding.
Give a digestible diet while in bed;
Closely observe the heart rate and heart rhythm at the early stage after radiofrequency ablation, and report it to the doctor if uncomfortable, and check the ECG, echocardiogram and chest radiograph if necessary;
If the feeling of tachycardia recurs after the operation, but it does not really happen, you don't need to be nervous and don't need special treatment;
Normal activity can resume after 1 week;
If there is a relapse after discharge, the nearest ECG should be recorded in time, and the surgeon should be contacted to determine the next treatment plan.
Anticoagulant therapy is required after radiofrequency ablation, and anticoagulant drugs are generally required for 1-3 months, depending on the patient's heart rhythm, age, and general conditions. The application of other auxiliary drugs is mainly the use of amiodarone after atrial fibrillation ablation, which can be taken in accordance with the doctor's order to achieve the desired effect. ^[1]