心律失常的消融

Catheter ablation is a procedure that uses radiofrequency energy (similar to microwave heat) to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. 破坏这种组织有助于恢复心脏的正常节律. Catheter ablation destroys the abnormal tissue without damaging the rest of the heart. 这个过程也被称为射频消融.

人们为什么要做导管消融?

Special cells in your heart create electrical signals that travel along pathways to the chambers of your heart. These signals make the heart’s upper and lower chambers beat in the proper sequence. Abnormal cells may create disorganized electrical signals that cause irregular or rapid heartbeats called arrhythmias. When this happens, 你的心脏可能不能有效地泵血，你可能会感到头晕, 气短，虚弱. 你可能还会感到心跳加速.

Medications are used to treat rapid and irregular heartbeats in many people. But they don’t work for everyone, and they may cause side effects in some people. 在这种情况下，医生可能会建议导管消融. 这个过程通常用于治疗一种叫做 室上性心动过速, or SVT, which occurs because of abnormal conduction fibers in the heart. Catheter ablation is also used to help control other heart rhythm problems such as atrial flutter and 心房纤颤.

有哪些风险??

这个过程通常是安全的. 并发症很少，但可能包括:

• Arrhythmias
• 插入导管处出血
• Infection
• Blood clots
• 心脏或血管损伤
• 导管插入处的动脉受损

我该如何准备手术呢?

• Your doctor will tell you what to eat and drink during the 24 hours before the test.
• You’ll be asked not to eat or drink anything for at least 6 to 8 hours before the procedure.
• 告诉你的医生你服用的任何药物. 他们可能会要求你在考试前不要服用. 不要停药，除非你的医生告诉你.
• 把你所有的首饰留在家里.
• 手术后安排人开车送你回家.

导管消融过程中会发生什么?

A doctor with special training performs the procedure along with a team of nurses and technicians. The procedure is done in a hospital electrophysiology (EP) or cath lab.

• A nurse will put an IV (intravenous line) into a vein in your arm so you can get medicine (anesthesia) to prevent pain. You may also get a medicine (sedative) to help you relax but you will be awake during the procedure.
• The nurse will clean and shave the area where the doctor will be working. 这通常在你的腹股沟.
• The nurse will give you a shot — a local anesthetic — to numb the needle puncture site.
• The doctor will make a needle puncture through your skin and into the blood vessel (typically a vein, 但有时是腹股沟的动脉, arm, 颈部或大腿上部. A small straw-sized tube (called a sheath) will be inserted into the blood vessel. The doctor will gently guide a catheter (a long, thin tube) into your vessel through the sheath. 视频屏幕将显示导管的位置. You may feel some pressure in your groin, but you shouldn’t feel any pain.
• 医生插入了几个长, 带导线的细管, 称为电极导管, 穿过鞘，把这些管子送入你的心脏.
• 定位引起心律失常的异常组织, the doctor sends a small electrical impulse through the electrode catheter. This activates the abnormal tissue that is causing your arrhythmia. Other catheters record the heart’s electrical signals to locate the abnormal sites.
• The doctor places the catheter at the exact site inside your heart where the abnormal cells are. Then, a mild, painless, radiofrequency energy (similar to microwave heat) is sent to the tissue. This destroys heart muscle cells in a very small area that are responsible for the extra impulses that caused your rapid heartbeats.
• 导管消融可能需要4小时或更长沙巴足球体育平台. Your doctor will determine if you may go home the same day or if you have to stay overnight. 

导管消融后会发生什么?

你会被转移到恢复室接受监护. The sheath usually stays in your leg for several hours after catheter ablation. 在这段沙巴足球体育平台里，你必须平躺.

在医生或护士取出鞘后:

• A nurse will put pressure on the puncture site to stop the bleeding.
• You should keep your leg straight for several hours after the doctor or nurse removes the sheath. 你什么时候可以起床，我们会通知你的.
• Your heartbeat and vital signs (pulse and blood pressure) will be monitored.
• 如果你发现有任何肿胀，马上告诉你的医生或护士, 穿刺处疼痛或出血, 或者如果你胸痛.
• Before you leave the hospital, you'll be given written instructions about what to do at home.
• 还有你的常规药物, you may be prescribed others to assist in your recovery after the procedure.

我回家后会发生什么?

Follow the instructions you were provided before leaving the hospital. Most people can return to their normal activities the day after they leave the hospital, 除了少数例外. 手术后第一周:

• 在医生允许之前不要开车.
• Avoid heavy physical activity until your health care professional says it’s safe.
• 不要举起重量超过10磅的东西.
• Don’t take a bath, swim or otherwise submerge the incision site in water.
• 保持切口部位清洁干燥. Call your health care professional if you notice any signs of infection.
• If the site starts to bleed, lie flat and press firmly on top of it. 叫人打电话给医生或医院吗.

Call 911 if:

• 穿刺处肿得很快.
• Bleeding from the puncture site does not slow down when you press on it firmly.
• You feel pain or discomfort in your chest that moves into your neck, jaw or arm.
• 脸下垂，手臂无力，说话困难

如果出现下列情况，请致电医生:

• Your leg with the puncture becomes numb or tingles, or your foot feels cold or turns blue.
• 穿刺处周围的区域看起来更淤青.
• 斑点开始膨胀，或者液体从它流出.
• 你觉得胃不舒服或者出汗很多.
• 你的心跳过快或不规则.
• 你感到呼吸急促.
• 你感到头晕目眩，不得不躺下. 

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