L’ablazione cardiaca è una metodica utilizzata nel trattamento di lunga durata per molti tipi di aritmie (esempio fibrillazione atriale- tachicardia parossistica sopraventricolare, eccetera). La procedura individua e neutralizza (pulisce, toglie, da qui il termine ablazione) le cellule del muscolo cardiaco responsabili dell’aritmia, ovvero dell’anomalia nel sistema elettrico del cuore. Ciò consente di ripristinare il normale battito cardiaco. Una procedura di ablazione cardiaca viene eseguita da un cardiologo specializzato in elettrofisiologia. Ecco maggiori dettagli sui rischi, la convalescenza ed altro.
Come prepararsi ad una ablazione cardiaca
Lo specialista di riferimento di solito spiega al paziente preventivamente tutte le problematiche relative alla procedura e come si esegue, oltre che cosa fare prima del ricovero in ospedale. Importante sarà ad esempio determinare la sospensione eventuale di alcuni farmaci. Si possono effettuare anche a supporto determinate indagini diagnostiche come le analisi del sangue, una radiografia, ed un ECG (elettrocardiogramma).
Importante segnalare preventivamente al medico se si ha qualche forma di allergia, si sta assumendo viagra o si è in stato di gravidanza.
Anestesia ed intervento
Per via endovenosa, nel braccio, sarà somministrato un farmaco per la cosiddetta sedazione cosciente: significa che rilassa e tende a far addormentare, ma non in modo generale, si rimane consapevoli di ciò che accade intorno e si è in grado di parlare con il personale sanitario senza sentir alcun dolore. Vengono poi inseriti dei cateteri nelle vene, in uno o entrambi i lati dell’ inguine o del collo al fine di accedere al cuore. Nello specifico, durante la procedura, dei sottili cateteri sono inseriti in una vena della gamba, a partire dalla zona inguinale. Il medico delicatamente spingerà questi cateteri fino in fondo al cuore guidato da strumentazioni particolari con Raggi X. Prima di eseguire l’ablazione reale, la specifica zona del cuore che causa l’aritmia deve essere identificata. A tale scopo, viene creata una “mappa” elettrica del cuore. Questo viene fatto registrando l’attività elettrica del muscolo cardiaco, mentre un’aritmia è in corso. Una volta che il medico ha individuato la fonte del problema, si procederà con l’ablazione attraverso un sistema a radiofrequenza. A seconda della complessità dell’aritmia, la procedura potrà durare 1 o più ore. Per qualunque fastidio o disagio si potrà interloquire con il personale sanitario presente in sala. Il tutto potrà essere eseguito in Day hospital o con ricovero di una notte a seconda dei casi. Meglio evitare di guidare o svolgere attività impegnative almeno nelle prime 24 ore successive all’ablazione cardiaca.
Rischi e convalescenza
Il recupero da una procedura di ablazione transcatetere è di solito veloce. Molte persone sono in grado di riprendere la maggior parte delle loro normali attività già 24 ore dopo. Sul sito dell’inserimento del catetere, dopo la chiusura della ferita alcune persone sperimentano lividi e si sentono un piccolo grumo duro. Questo è normale e andrà via in pochi giorni. Se invece si hanno uno qualsiasi dei seguenti sintomi è opportuno rivolgersi al medico:
• Sanguinamento nel punto di inserimento
• Aumento del dolore
• Dolore toracico
• Mancanza di respiro
• Sensazione di freddo, gonfiore, intorpidimento o sul braccio o della gamba del sito di inserzione
• Se lividi o grumo nel punto di inserimento diventa più grande
• Febbre oltre i 38°C
• Ritorno di sintomi di aritmia
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