Cardiac Ablative Technologies

Device technologies to treat cardiac arrhythmia continue to advance at a rapid pace. This is a highly competitive field with numerous corporate powerhouses playing significant roles. The primary goals for treatment of arrhythmia are to: (1) alleviate symptoms and improve an individual’s quality of life; (2) prolong the patient’s life by preventing complications such as ventricular tachycardia/fibrillation, syncope, and/or stroke; and (3) reduce an individual’s dependency on pharmacologic therapies that often carry significant side effects. Pharmacologic treatment has been the mainstay for management of most cardiac arrhythmias, although in recent years, implantable devices and ablation have become increasingly more important. In this chapter, we review several ablation technologies that are in current use as well as others that are being developed and investigated. This review contains descriptions of: (1) various energy sources; (2) mechanisms of action for lesion formation; (3) required power sources; (4) the variety of catheters used to apply these therapies; (5) potential treatment complications; and (6) recent sensor technologies that are being developed to improve therapeutic efficacy and/or minimize complications. An additional ablation technology that has been investigated and is currently in use for atrial fibrillation ablation is Pulse Field Ablation (PFA), covered in Chap. 9.