Pulmonary vein isolation
The Circumferential or linear pulmonary vein is an electro-surgical, minimally invasive method for the treatment of idiopathic or paroxysmal (anfallsweisem) atrial fibrillation . A catheter is inserted through a venous blood vessel in the groin through the vena cava into the right atrium and placed through the heart septum in the left atrium. From there, the walls of the four pulmonary veins (pulmonary veins) are scanned with a measuring catheter and a three-dimensional reconstruction, the so-called map , is created in the computer . The pulmonary vein muscles near the atrium are then obliterated using high-frequency current catheter ablation in order to prevent the myoelectric impulses from being transmitted to the atrium. The procedure takes about 1–2 hours. In contrast to drug therapy, in which the sensitivity of the atrial cells and thus impulse transmission is only temporarily reduced, pulmonary vein isolation is permanent. One of a US research group led by Dr. John Day of Salt Lake City, presented at the Denver Heart Rhythm 2010 Convention, showed that patients with atrial fibrillation after catheter ablation had a significantly lower risk of Alzheimer's disease and dementia than drug-treated patients.
The procedure is now established in many hospitals with major cardiology and clinical electrophysiology . Approximately 25% of patients need a second operation after a few months to close any remaining gaps in the ablation lines. The overall success rate is given as around 80%. Serious complications occur in about 2% of treatments, such as apoplexy , pulmonary stenosis , perforation of the esophagus, and pericardial effusion . More often there are complications (e.g. vascular injuries, secondary bleeding) at the puncture site in the groin.
