Possibilities and limitations of catheter ablation of tachycardia arrhythmia

Catheter ablation has become an alternative to other non-pharmacological forms of antiarrhythmic therapy. Since supraventricular arrhythmias were first treated by ablation of the AV-conduction system, the clinical use of the technique has recently been extended to treat accessory pathways or ventricular tachycardias. The results of experiences from a number of clinical centers are available. To improve clinical applicability and to avoid complications, besides direct-current ablation, new technologies have been tested experimentally and in some cases already applied to patients. Whereas catheter ablation with radio-frequency alternating current has already been used in patients, the application of laser technology to ablation of arrhythmogenic myocardium has been limited to open heart surgery. Both techniques may offer improvements regarding precision and safety aspects of the method. To perform catheter ablation, a multitude of prerequisites concerning organisatory and safety aspects has to be fulfilled. Thus far, catheter ablation should only be performed in clinical centers with the facilities for cardiac surgery.