Treatment Options for Tachyarrhythmia: Understanding Radiofrequency Ablation

Tachycardia and the Role of Radiofrequency Ablation
Experiencing heart palpitations, shortness of breath, dizziness, chest tightness, or chest pain? These could be signs of tachyarrhythmia — a condition characterized by an abnormally fast heartbeat. For many patients, radiofrequency ablation (RFA) offers a highly effective, minimally invasive treatment option that targets the root cause of the condition.

Understanding the Risks of Tachycardia

A normal resting heart rate typically ranges between 60 and 100 beats per minute. When the heart rate exceeds 100 beats per minute at rest, it is classified as tachycardia. While temporary increases in heart rate due to exercise, stress, or caffeine are normal, persistent or sudden rapid heartbeats could signal a more serious underlying condition.

Pathological tachycardia can result from congenital or acquired heart abnormalities, with heart rates often reaching 180–200 beats per minute or higher. This condition can be categorized as either paroxysmal (intermittent) or sustained. Paroxysmal episodes can last from minutes to days, and patients may feel completely normal between episodes. However, during an episode, symptoms such as palpitations, fatigue, low blood pressure, and even fainting may occur.

Potential Complications of Untreated Tachycardia

If left untreated, chronic tachycardia can lead to tachycardiomyopathy — a condition where the heart muscle weakens due to prolonged rapid heartbeats. This can progress to heart failure, dangerous arrhythmias, and in severe cases, sudden cardiac death. Even in less severe cases, tachycardia can pose significant risks for individuals in high-responsibility professions such as drivers or those working at heights, where a sudden episode could be life-threatening.

What Is Cardiac Radiofrequency Ablation?

Radiofrequency catheter ablation is a minimally invasive procedure used to treat various types of tachyarrhythmias. It involves the use of catheters to deliver radiofrequency energy — a form of high-frequency electromagnetic waves — directly to specific areas of heart tissue responsible for abnormal electrical signals.

How the Procedure Works

During the procedure, electrode catheters are inserted through blood vessels — typically in the groin or neck — and guided into the heart under fluoroscopic imaging. Once in place, the catheters map the heart's electrical activity to locate the exact origin of the arrhythmia.

Once identified, the physician delivers high-frequency energy (500–750 kHz) to the targeted area, generating heat that destroys the abnormal tissue. This process, known as ablation, creates a small, precise lesion (usually 2–3 mm in size) that disrupts the faulty electrical pathways causing the rapid heartbeat.

Advantages of Radiofrequency Ablation

One of the major benefits of RFA is its minimally invasive nature. Most procedures are performed under local anesthesia, allowing patients to remain awake and communicate with the medical team. Recovery times are typically short, with most patients discharged within 24 hours and able to resume normal activities within a few days.

Although rare, some patients may experience a recurrence of tachycardia after the procedure. However, repeat ablation can significantly improve long-term success rates. With high cure rates and minimal discomfort, RFA is considered the gold standard for treating many types of tachyarrhythmia.