Hybrid Ablation Therapy for Complex CHF 

A combination of surgical and percutaneous therapies can be used to treat patients with complex congestive heart failure and arrhythmias.  

The heart is a complex muscle that pumps blood throughout the body’s circulatory system. Congestive heart failure (CHF) is a type of heart failure that can occur due to coronary artery disease, diabetes and high blood pressure. In someone with CHF, the heart stops being able to pump blood as efficiently as it should, and blood returns to the heart faster than the heart can pump it back out to the rest of the body. As a result, blood backs up and forces its way through the walls of blood vessels, leading to fluid buildup in the lungs, liver, abdomen and lower body. 

Different types of heart arrhythmias—or abnormal heartbeats caused by electrical misfiring in specialized heart cells—can also affect people with CHF. This results in a highly complex heart condition in which each individual issue influences the progression of the other. For this reason, someone with CHF and an arrhythmia is at a higher risk for death and effectively treating the problem is difficult.  

However, a minimally invasive hybrid procedure involving both a surgical and percutaneous approach to ablation and synchronization may be an option. 

Conditions Treated 

Hybrid therapy for complex CHF essentially treats heart arrhythmias, such as atrial fibrillation (AFib or AF). For example, AFib occurs when the heart’s upper chambers (atria) quiver instead of contracting and releasing as normal to pump blood into the heart’s lower chambers (ventricles). When combined with congestive heart failure, an arrhythmia can further complicate the heart’s ability to move blood throughout the body.   

Procedure Details 

Hybrid ablation therapy is performed by a cardiothoracic surgeon and an electrophysiologist. The procedure typically follows this process: 

• A cardiothoracic surgeon will make a few incisions in a patient’s chest wall.  
• Slim surgical tools are inserted into the incisions. 
• Using radiofrequency energy or cold nitrous oxide, the surgeon creates scar tissue by ablating certain areas of the surface of the heart muscle. 
• Separately, an electrophysiologist will insert catheters into a vein in the groin area. 
• The catheters are guided to the area inside the heart that causes abnormal heart rhythm.  
• The catheters deliver high-frequency electrical energy that creates scar tissue, effectively disrupting the electrical pathway of the abnormal heart rhythm.  

What to Expect 

Hybrid ablation therapy for complex congestive heart failure requires a hospital stay of at least a few days so a medical team can monitor a patient’s status and adjust medications as needed. Since hybrid ablation is a minimally invasive procedure that requires only a few incisions, it has a much lower risk for complications, a reduced recovery time and a shorter hospital stay compared to open heart surgery.     

Effectiveness 

Patients with both congestive heart failure and heart arrhythmias often have limited options when medications and other non-surgical methods fail to provide relief. But hybrid ablation therapy is an effective solution that improves quality of life and offers better long-term results than other surgical methods.  

At Tampa General Hospital, we always take a multidisciplinary approach to care and this is nowhere more evident than in a procedure like hybrid ablation therapy. Our renowned team of electrophysiologists, cardiothoracic surgeons and other heart and vascular specialists work tirelessly together to provide patients with world-class care, regardless of the complexity of their condition.