Electrophysiological Studies and Radiofrequency Ablation

Table of Contents

Cardiac arrhythmias, characterised by abnormal electrical activity in the heart, disrupt the regular rhythm of contractions and pose significant risks to human health. The precise coordination of electrical signals is vital for the heart’s pumping function, ensuring adequate delivery of oxygen and nutrients throughout the body. When arrhythmias compromise this delicate process, the consequences can be wide-ranging, from minor discomfort to life-threatening cardiovascular complications. Therefore, understanding the mechanisms underlying arrhythmogenesis and their clinical implications is crucial for effectively preventing, diagnosing, and managing this prevalent and potentially devastating condition. Fortunately, Electrophysiological Studies (EPS) and Radiofrequency Ablation (RFA) offer minimally invasive solutions to restore normalcy to the heart’s rhythm.

What are EPS and RFA?

Electrophysiological Study (EPS): This procedure uses electrical signals to examine the heart’s electrical activity. It involves inserting thin catheters, equipped with electrodes, into the heart through blood vessels in the groin. These electrodes map the heart’s electrical pathways, pinpointing the source of the arrhythmia. The doctor can also trigger abnormal rhythms during the procedure to further understand their origin.

Radiofrequency Ablation (RFA): Once the culprit cells are identified, RFA is used to eliminate them. Radiofrequency energy is delivered to these cells using the same catheters, effectively heating and destroying them. This targeted approach eliminates the source of the arrhythmia, restoring the heart’s natural rhythm.

Both EPS and RFA in cardiology are procedures that help to manage heart problems caused by arrhythmias effectively.

Arrhythmias, or irregular heartbeats, can arise from various malfunctions within the heart’s intricate electrical system. These disruptions can manifest in several ways, each posing unique challenges. They are:

Supraventricular Tachycardia (SVT) happens when the electrical signals regulating the heart’s pace malfunction above the ventricles, leading to a rapid and erratic heartbeat. This can cause palpitations, chest pain, dizziness, and even fainting.

Atrial fibrillation (AFib) is characterised by fibrillating chambers in the upper part of the heart, which means they are contracting rapidly and irregularly. This fibrillating disrupts the normal electrical flow, causing an irregular and often faster heartbeat. AFib can significantly impact blood flow, increasing the risk of stroke and heart failure.

Ventricular tachycardia (VT) originates in the heart’s lower chambers, the ventricles. This type of arrhythmia is particularly concerning due to its potential to degenerate into a life-threatening condition known as ventricular fibrillation (VFib), which can cause sudden cardiac arrest.

Fortunately, both EPS and RFA can help to diagnose and treat arrhythmias. By identifying the source of the electrical malfunction and precisely targeting the problem area with heat, these procedures can restore the heart’s natural rhythm and improve overall cardiovascular health.

EPS And RFA Cost In India:

Understanding EPS & RFA Treatment Cost in India

The price of EPS and RFA treatments in India can significantly differ depending on several factors. These factors include the chosen hospital, city, and case complexity. However, to provide a general range, you can expect to spend:

Electrophysiological Study (EPS): INR 22,200 to INR 29,600

Radiofrequency Ablation (RFA): INR 2,00,000 to INR 3,00,000

Here is a breakdown of some factors influencing the cost:

Hospital: Private hospitals generally charge higher fees than government-run facilities. Additionally, the reputation and expertise of the hospital can also impact the cost.

City: Costs can vary depending on the city where you undergo the procedure. Larger metropolitan cities often have higher costs than smaller towns.

The complexity of the case: More complex cases requiring longer procedure times or specialised equipment may incur higher charges.

Additional Costs: These may include consultation fees, pre-operative tests, medication, and follow-up appointments.

If you have to undergo either the EPS and RFA procedure in India, here are some resources:

Magnus Medi: https://magnusmedi.com/treatment-cost/eps-rfa/india/
IndiCure: https://www.indicure.com/eps-rfa-treatment-cost-in-india/
Cross Border Care: https://www.indicure.com/eps-rfa-treatment-cost-in-india/
HealthCareTripIndia: https://www.impactguru.com/info/eps-and-rfa-cost-in-india/

It is important to note that these are estimated costs. To get a more accurate estimate for your case, it is recommended to consult with your doctor and the hospital where you plan to undergo the procedure.

Getting Ready for EPS and RFA:

Before you undergo EPS and RFA procedures, your doctor will conduct a thorough assessment to ensure you are a good candidate and optimise your chances for a successful outcome. This involves a series of tests and consultations to understand your heart health comprehensively.

Diagnostic Tests:

Electrocardiogram (ECG): This simple test records the electrical activity of the heart, providing valuable insights into its rhythm and potential abnormalities.
Echocardiogram: This imaging technique utilises ultrasound waves to visualise the structure and function of the heart, revealing any underlying conditions that might impact the procedures.
Holter monitor: Worn for 24-48 hours, this portable device continuously records the heart rhythm, capturing any irregular patterns that may be missed during other tests.
Blood tests: These tests evaluate the blood sugar, electrolyte levels, and kidney function, ensuring vital processes function correctly before the procedure.

Preparing Yourself:

Taking a break from smoking: To ensure optimal healing and minimise complications, you will be asked to pause smoking for several weeks before the procedures.
Medication adjustments: Certain medications that affect blood clotting or heart rhythm may need to be adjusted or stopped before the procedures. Always keep your doctor informed about all medications and supplements you are taking.
Arranging transportation: As you will need to rest after the procedure, it’s crucial to arrange for a responsible adult to drive you home.

These steps proactively contribute to a smooth and successful EPS and RFA experience. By working with your healthcare team and following their guidance, you can optimise your preparation and set yourself up for a positive outcome.

What to Expect During EPS and RFA: EPS and RFA Procedure(s)

Electrophysiological Study (EPS):

Preparation:

During your EPS or RFA procedure, you will be required to wear a medical gown. You will also have to take off any jewellery, watches or any other metal objects that may interfere with the equipment or imaging. This helps ensure a smooth and successful procedure.
An intravenous (IV) tube shall be inserted into your arm to administer fluids and medications.
You will be given moderate sedation to help you relax and feel comfortable.

The Procedure:

1. Catheter Insertion: A thin, flexible tube called a catheter will be inserted inside a vein in your groin and carefully guided towards your heart using X-ray imaging.

2. Electrode Mapping: Once the catheter reaches your heart, it will have several electrodes at its tip that will record the electrical activity of your heart muscle. These electrodes will be positioned in different locations within your heart chambers to create a detailed map of its electrical pathways.

3. Induced Arrhythmia: Sometimes, your doctor may trigger abnormal heart rhythms during the EPS by stimulating your heart with electrical pulses. This helps identify the specific location and cause of your arrhythmia.

During the EPS, you may experience:

A slight fluttering or racing sensation in your chest, especially during induced arrhythmia.
Mild discomfort from the catheter being inserted and moved within your heart.
Warmth or tingling sensations in your legs due to the contrast dye used during X-ray imaging.

Radiofrequency Ablation (RFA):

Preparation:

The same preparation steps as for EPS will be followed.
Your doctor will study the results of your EPS to determine the specific location of the tissue to be ablated.

The Procedure:

Catheter Positioning: The same catheter used for the EPS will be positioned near the tissue causing the arrhythmia.
Radiofrequency Energy Delivery: The catheter tip will emit radiofrequency energy, which generates heat and destroys the targeted tissue. This heat destroys the abnormal cells responsible for your arrhythmia without damaging the surrounding healthy tissue.
Rhythm Monitoring: Throughout the RFA, your heart rhythm will be continuously monitored to ensure the procedure is effective and no complications arise.

During the RFA, you may experience:

A warm sensation in your chest as the radiofrequency energy is delivered.
Mild discomfort from the catheter being moved within your heart.

Following the Procedures:

You will be monitored in a recovery room for several hours to ensure your heart rhythm is stable and no complications occur.
You may experience some soreness or bruising at the catheter insertion site.
Most patients can go home the same day or the next day.

Recovery after EPS and RFA:

Following the procedures, you will be monitored for several hours to ensure your heart rhythm is stable. Most patients can go home the same day or the next day. Recovery typically takes a few days, and you will be asked to take it easy and avoid strenuous activity. Your healthcare provider will prescribe medications to manage your heart rhythm and prevent complications.

Radiofrequency ablation (RFA) is not just limited to treating heart problems. This versatile technology is also making waves in the field of cancer treatment.

How Does RFA Work for Cancer?

The principle behind RFA for cancer remains the same as for arrhythmia treatment. To reach the tumour, a thin needle electrode is inserted under image guidance, typically through the skin. Radiofrequency energy (microwaves) is then delivered through the electrode, generating heat that destroys the cancer cells.

RFA offers several advantages over traditional cancer treatments like surgery and radiation. They are:

Minimally invasive: The procedure is performed percutaneously, requiring no significant incisions. This minimises pain, scarring, and recovery time.
Precise targeting: RFA allows targeted tumour destruction while sparing surrounding healthy tissues.
Fewer side effects: Compared to surgery and radiation, RFA has fewer side effects, such as nausea, vomiting, and hair loss.
Repeatable: RFA can be repeated if the tumour recurs.

Types of Cancers Treated with RFA:

RFA is currently approved for treating certain types of cancer, including:

Liver cancer: RFA is a first-line therapy for small hepatocellular carcinomas (HCCs), which are the most common type of liver cancer.
Kidney cancer: RFA can treat small renal cell carcinomas (RCCs).
Lung cancer: RFA is an option for treating early-stage lung tumours that are located near the edge of the lungs.
Bone cancer: RFA can palliate pain caused by bone metastases.\

Challenges and Future of RFA in Cancer Treatment

While RFA offers significant benefits, particular challenges still need to be addressed:

Tumour size: RFA is currently not suitable for treating large tumours.
Tumour location: Tumors in difficult-to-reach areas may be challenging to treat with RFA.
Need for further research: More research is needed to determine the long-term effectiveness of RFA for various types of cancer. Despite these challenges, RFA is a promising tool in the fight against cancer. As technology advances and research continues, RFA has the potential to become an increasingly important treatment option for a broader range of cancers.

Best hospitals for EPS and RFA in India.

There are many well-known hospitals in India that are equipped with medical experts and state-of-the-art infrastructures for carrying out EPS and RFA.

Top Hospitals in India for Electrophysiological Study (EPS) and Radiofrequency Ablation (RFA):

1. Fortis Memorial Research Institute:

Renowned for its experienced team of cardiac electrophysiologists and cutting-edge technology.
Offers advanced 3D mapping systems for precise ablation procedures.
Boasts high success rates for EPS and RFA procedures.
Locations: Delhi, Gurgaon, Bangalore, Kolkata, Mumbai, Chennai.

2. Amrita Institute of Medical Sciences (Amrita Hospital Faridabad):

Equipped with the latest technology for EPS and RFA, including the CARTO 3 system for 3D mapping.
The highly skilled team of doctors has extensive experience in complex cases.
Provides comprehensive care encompassing diagnosis, treatment, and follow-up.

3. W Pratiksha Hospital:

Recognised for its excellence in cardiac electrophysiology services.
Offers advanced techniques for EPS and RFA, including the CARTO 3 system.
Experienced team of doctors and dedicated support staff.
Located in Gurgaon.

4. Indraprastha Apollo Hospitals:

It is among the leading healthcare providers in India with a strong reputation in cardiology.
Offers advanced technology for accurate diagnosis and effective treatment of arrhythmias.
Experienced team of doctors and well-equipped facilities.
Locations: Delhi, Mumbai, Ahmedabad, Kolkata, Chennai, Bangalore.

5. BLK Super Speciality Hospital:

Renowned for its comprehensive cardiac care, including advanced electrophysiology services.
Offers high-tech equipment and modern infrastructure.
Experienced team of doctors with expertise in complex arrhythmias.
Located in Delhi.

Other notable hospitals:

Medanta – The Medicity (Gurgaon, India)
Narayana Health City (Bangalore, India)
Kokilaben Dhirubhai Ambani Hospital (Mumbai, India)
Apollo Hospitals (Chennai, India)
All India Institute of Medical Sciences (Delhi, India)

Aspects to keep in mind when choosing a hospital for EPS and RFA:

Experience and expertise of the doctors: Choose a hospital with a group of experienced and qualified cardiac electrophysiologists.
Technology and facilities: Look for a hospital equipped with the latest technology for EPS and RFA procedures, such as 3D mapping systems.
Success rates: Research the hospital’s success rates for EPS and RFA procedures.
Location and affordability: the location of the hospital and the cost of the treatment.

References:

Lyfboat: https://www.lyfboat.com/services/
HBG Medical Assistance: https://hbgmedicalassistance.com/
Narayana Health: https://www.narayanahealth.org/procedures/electrophysiology-ep-study
Marengo CIMS Hospital: https://www.cims.org/electrophysiology-studies-and-rf-ablations/

FAQ

What is EPS and RFA?

A: EPS and RFA are minimally invasive procedures that help doctors study the heart’s rhythm through electrical signals and also help rectify any errors. EPS is used to identify the errors, and RFA is used to rectify them.

What is the success rate for EPS and RFA procedures?

A: EPS and RFA are very successful. It is shown that the procedures are usually thought to have a 90% success rate.

How long do the EPS and RFA procedures last?

A: EPS and RFA procedures have been known to last 3 to 4 hours for both procedures together. The patient, in most cases, can go home a day or two after the procedure.

What are the benefits of EPS and RFA?

A: EPS and RFA are procedures that are minimally invasive. Hence, they are safer and have a higher success rate. The healing time after the procedure is also less.

How can one take care of themselves after undergoing EPS and RFA procedures?

A: The details of how one can take care of themselves will be discussed with the patient in detail by their healthcare provider. The bottom line is that one should avoid any kind of heavy activity for the weeks that follow the procedure.

Conclusion

Arrhythmias can disrupt lives and cause significant distress. Fortunately, medicine has evolved through procedures like electrophysiological study (EPS) and radiofrequency ablation (RFA), and they can be diagnosed and treated. These minimally invasive procedures boast high success rates, restoring normal heart rhythm and improving the quality of life for countless patients.

But the fight for health extends beyond arrhythmias. Cancer, a life-threatening disease, often requires extensive treatment, including surgery, radiation, and chemotherapy. Unfortunately, these treatments can be costly, with unpredictable durations and ever-evolving costs. It’s common for patients and their families to face financial hardship, struggling to maintain adequate funding for their essential healthcare.

In such moments of uncertainty, crowdfunding platforms like Ketto emerge as beacons of hope. Ketto, a crowdfunding platform in India, empowers individuals and organisations to raise funds for medical treatments, including life-threatening illnesses like cancer. This platform bridges the gap between those who require financial help and those who can provide them with the same, allowing patients to focus on healing while their communities rally behind them.

Through Ketto, individuals can share their stories, connect with contributors, and receive the financial support they need to continue their treatment journey. Regardless of size, contributions collectively create a powerful force for good, helping patients overcome financial barriers, undergo treatment and get better.

So, whether one is facing issues related to arrhythmia or cancer, remember that advanced medical procedures like EPS and RFA exist to offer solutions and platforms like Ketto stand ready to provide financial assistance. By using these resources and the community’s unwavering support, you can navigate the path towards improved health and a brighter tomorrow.