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Dr. Ratika Parkash MD, FRCPC Cardiologist Halifax, NS

MD, FRCPC Cardiologist Halifax, NS

BIO:

Dr. Parkash works at the Nova Scotia Health Authority.

Dr. Parkash is co-principal investigator of a Heart and Stroke Foundation-funded study of the effects of cardiac re-synchronization therapy (CRT) on ventricular arrhythmias in patients with advanced heart failure.

Dr. Parkash received the Greg Ferrier Award for her proposal seeking funding for this study, which ranked first in the Heart and Stroke Foundation’s 2007 competition. In addition to her expertise in heart rhythm problems, Dr. Parkash has a masters degree in clinical epidemiology from the Harvard School of Public Health that enables her to conduct health services and outcomes studies that complement her clinical research. She has already set up a registry of heart patients in Nova Scotia and Prince Edward Island who have been referred to receive a defibrillator.

In 2008, Dr. Parkash received a Dalhousie Medical Research Foundation Award of Excellence in Clinical Research for her outstanding accomplishments. In addition, she has been the recipient of the CIHR Randomized Clinical Trials Mentoring Award in 2008.

( Dr. Ratika Parkash, Cardiologist, Halifax, NS ) is in good standing with the College of Physicians and Surgeo

Dr. Ratika Parkash, MD, FRCPC, Dalhousie Medical Research,Cardiologist, discusses cardiac ablation, the different techniques used and risks involved with the procedure.

Ablation is a procedure that is performed in the heart, to cauterize the tissues in the heart that can lead to dangerous or other heart rhythm problems. Atrial fibrillation is one of the most common ablation procedures that we perform today.

Ablation for atrial fibrillation will reduce your burden of atrial fibrillation. What we do is we put wires up to the heart and go to the left side of the heart where atrial fibrillation originates from. We then will cauterize in the left side of the heart to eliminate the triggers that cause atrial fibrillation.

These triggers are the ones that cause the heart to become erratic. Elimination of these triggers can be difficult with an ablation, but some patients will be symptom free up to 70 percent of the time after one ablation. In certain cases, the success rate for the ablation may not be as high, but these can be discussed with your heart rhythm specialist.

Catheter ablation for atrial fibrillation is generally for patients who have a higher symptom burden. For example, a patient who when they go into atrial fibrillation are unable to do their usual activities, become short of breath, have chest pain or feel lightheaded.

Those patients are the ones that go forward for an ablation. Often those patients have already tried drugs to try and control their rhythm problem, but need the ablation to reduce their symptom burden dramatically.

There are two kinds of ablation that can be performed for atrial fibrillation. There’s cryoablation and there is radiofrequency ablation. The main difference between the two is the type of energy that is used to cauterize the tissues in the heart.

In cryoablation, it is a freezing type of therapy, and this therapy uses a balloon to insert inside the left side of the heart and to freeze around the balloon. In catheter ablation, it is a heating type of energy called radiofrequency that is used to cauterize the tissues and a wire is used rather than a balloon.

There are complications with ablation for atrial fibrillation. These can include stroke, one in 200, perforation of the heart, one in 500, and there is a potential complication where the back of the heart can connect to the esophagus, which is the feeding tube behind the heart, and that occurs one in 5,000 but can be fatal.

These are important complications to consider when an ablation is being offered. If you would like to have more information on ablation for atrial fibrillation, your GP can refer you on to a heart rhythm specialist to discuss these procedures in greater detail.

Presenter: Dr. Ratika Parkash, Cardiologist, Halifax, NS

Local Practitioners: Cardiologist

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