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A comprehensive guide on EPS + RPA ablation treatment in India

15 Jun, 2024

Blog author iconDr. Divya Nagpal
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Interested in EPS + RPA ablation treatment and how it works in India? This guide is your go-to for understanding this advanced heart rhythm disorder treatment. What's involved? Where can you find hospitals that specialize in it? We've got the answers. Discover the benefits, risks, and outcomes of EPS + RPA ablation, and why India is a top choice for cardiac care. Whether you're exploring options for yourself or a loved one, dive into the details of this cutting-edge procedure and what makes India a leader in heart health.


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Procedure

EPS + RPA Ablation Procedure

An Electrophysiological Study (EPS) is a diagnostic test that checks how your heart's electrical system is working and helps diagnose abnormal heart rhythms, known as arrhythmias. During an EPS, a thin, flexible wire called an electrode catheter is carefully guided through a blood vessel to your heart. This catheter then records the heart's electrical signals from inside. By doing this, doctors can pinpoint the specific areas in your heart that might be causing the irregular rhythms. EPS is crucial for understanding and treating heart rhythm issues effectively.

Steps Involved in EPS:

1. Preparation: The patient is usually given a sedative to help them relax and ensure comfort throughout the procedure. Local anaesthesia is applied to the catheter insertion site to minimize any discomfort. Patients are typically instructed to avoid eating or drinking for several hours before the procedure. Additionally, certain medications, especially those affecting heart rhythm, may need to be temporarily discontinued as per the doctor’s instructions.

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2. Insertion of Catheters: Catheters are inserted through veins in the groin, neck, or arm. Using fluoroscopy, a type of real-time X-ray imaging, the doctor carefully guides the catheters through the blood vessels to the heart. The insertion sites are meticulously cleaned and sterilized to prevent any risk of infection. The catheters are then positioned within specific areas of the heart to facilitate accurate recording and mapping of electrical activity.


3. Recording Electrical Activity: The electrode catheters are strategically positioned in different regions of the heart to measure its electrical signals. These catheters continuously record the heart's electrical activity, providing a comprehensive map of the heart’s conduction system. The recorded data is transmitted to a monitor, where the doctor can observe and analyze the heart’s electrical patterns in real time, helping to identify abnormal rhythms.

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4. Stimulation of the Heart: The doctor may use the catheters to deliver controlled electrical impulses to the heart. These impulses are designed to stimulate the heart and induce arrhythmias, thereby replicating the patient's symptoms in a controlled environment. This process helps pinpoint the exact locations within the heart responsible for the abnormal rhythms, allowing for precise diagnosis and treatment planning.


5. Diagnosis: Based on the recorded electrical activity and the heart’s response to the induced stimulation, the doctor can diagnose the type and location of the arrhythmias. The detailed information gathered from the EPS is crucial for determining the most appropriate treatment plan, which may include medication, lifestyle changes, further monitoring, or potentially an ablation procedure to correct the arrhythmia.

Right Pulmonary Artery (RPA) Ablation

Right Pulmonary Artery (RPA) Ablation: RPA Ablation is a treatment procedure used to correct arrhythmias. During this procedure, the problematic areas in the heart, which are causing the abnormal electrical signals, are destroyed using heat (radiofrequency ablation) or cold (cryoablation).


Steps Involved in RPA Ablation:

1. Preparation: Before the procedure, the patient may receive either sedation or general anaesthesia to ensure comfort and immobility during the procedure. Pre-ablation tests, including blood tests, imaging studies, and other assessments, are conducted to ensure the patient is fit for the procedure. The patient is typically advised to avoid eating or drinking for a certain period before the procedure and to stop taking certain medications as directed by the doctor.


2. Insertion of Catheters: Catheters are inserted through veins in the groin, neck, or arm, similar to the EPS procedure. Using fluoroscopy, the doctor guides the catheters through the blood vessels to the heart. Additional catheters may be positioned to deliver the ablation energy. The insertion sites are cleaned and sterilized to prevent infection, and the catheters are carefully placed in the heart to target the areas responsible for abnormal electrical signals.


3. Mapping: Using the data from the EPS, the heart's electrical activity is mapped in real time to identify the exact areas causing arrhythmias. Detailed mapping ensures precise targeting during the ablation. The doctor confirms the target areas using electrical stimulation, ensuring the problematic tissues are accurately identified before proceeding with ablation.


4. Ablation: Once the problematic tissue is located, the catheter delivers the chosen form of energy, either radiofrequency (heat) or cryoablation (cold), to destroy the abnormal tissue. Continuous monitoring is conducted throughout the ablation to ensure its effectiveness and to prevent damage to surrounding healthy tissue. The ablation process may involve delivering multiple bursts of energy to completely treat the targeted areas.


5. Post-Ablation Monitoring: After the ablation, the heart’s electrical activity is monitored to ensure the arrhythmia has been successfully corrected. The catheters are carefully removed, and pressure is applied to the insertion sites to prevent bleeding. The patient is then monitored in a recovery area for several hours to observe for any immediate complications and to ensure stability before being discharged.


Patients are usually monitored for several hours after the procedure to ensure there are no immediate complications. Most patients can return home the same day or the next day, with instructions to avoid strenuous activities for a few days. Regular follow-up appointments are essential to monitor the heart’s activity and ensure the arrhythmia does not recur. Additional treatments or lifestyle modifications may be recommended based on the patient’s progress and overall health.

Combined EPS + RPA Ablation Procedure:

When both EPS and RPA Ablation are combined, the procedure typically follows these detailed steps:


1. Sedation/Anesthesia: The patient is either sedated or given general anaesthesia to ensure they remain comfortable and still throughout the procedure. This helps minimize any discomfort and allows the doctor to perform the procedure without interruptions. The type of anaesthesia used depends on the patient’s health and the complexity of the procedure.


2. Insertion of Catheters: Catheters are inserted through veins in the groin, neck, or arm. Using fluoroscopy, the catheters are carefully guided through the blood vessels to the heart. The insertion sites are cleaned and sterilized to prevent infection. The catheters are positioned within specific areas of the heart, ready to record electrical activity and deliver ablation therapy as needed.


3. EPS Conducted: The electrical activity of the heart is recorded and analyzed using the electrode catheters. These catheters measure the heart's electrical signals, providing a detailed map of the heart’s conduction system. The data is transmitted to a monitor, where the doctor can observe and analyze the heart’s electrical patterns in real-time, identifying any abnormal rhythms.


4. Mapping: Detailed mapping of the heart’s electrical activity is conducted in real-time to identify the exact areas causing arrhythmias. The problematic areas are confirmed using electrical stimulation to ensure accurate targeting. This mapping process is crucial for planning the ablation therapy and ensuring its effectiveness.


5. Ablation: Once the problematic tissue is accurately located, the catheter delivers energy, either radiofrequency (heat) or cryoablation (cold), to destroy the abnormal tissue. Continuous monitoring is conducted throughout the ablation to ensure its effectiveness and to prevent damage to surrounding healthy tissue. The ablation process may involve delivering multiple bursts of energy to completely treat the targeted areas.


6. Post-Ablation Monitoring: After the ablation, the heart’s electrical activity is monitored to ensure the arrhythmia has been successfully corrected. The catheters are carefully removed, and pressure is applied to the insertion sites to prevent bleeding. The patient is then monitored in a recovery area for several hours to observe for any immediate complications and to ensure stability before being discharged.


The patient is monitored post-procedure for any complications. They are typically observed for several hours to ensure there are no immediate issues such as bleeding or arrhythmias. Most patients can return home the same day or the next day, with instructions to avoid strenuous activities for a few days. Regular follow-up appointments are essential to monitor the heart’s activity and ensure the arrhythmia does not recur. Additional treatments or lifestyle modifications may be recommended based on the patient’s progress and overall health.

Benefits of Combined EPS + RPA Ablation:

  • Accurate Diagnosis: EPS provides a precise map of the heart’s electrical activity, aiding in targeted RPA ablation.

  • Effective Treatment: RPA ablation effectively eliminates arrhythmias, improving quality of life and reducing symptoms.

  • Minimally Invasive: Both procedures are minimally invasive, leading to quicker recovery and fewer complications compared to surgery.

  • Reduced Medication Dependence: Successful ablation can reduce or eliminate the need for long-term medication management of arrhythmias.

  • Improved Long-Term Outcomes: By restoring normal heart rhythm, EPS + RPA ablation reduces the risk of future complications and enhances overall health outcomes.


  • Best Hospitals for EPS + RPA Ablation in India

    1. Apollo Hospitals, Chennai:

    Apollo Hospital

    Specialties:

    • Oncology: Offers comprehensive cancer care, including medical oncology, surgical oncology, radiation oncology, and advanced therapies like proton therapy (first in South Asia) and bone marrow transplant.
    • Cardiology: Renowned for advanced cardiac surgeries, minimally invasive procedures, interventional cardiology, and electrophysiology services.
    • Gastroenterology: Provides a full spectrum of gastroenterological services, including diagnostic and therapeutic endoscopy, liver disease management, and advanced GI surgeries.
    • Orthopedics: Specializes in joint replacement surgeries, sports medicine, spine surgery, and pediatric orthopaedics.
    • Neurology: Offers comprehensive neurological care, including stroke management, epilepsy treatment, neurodegenerative disease management, and brain tumour surgery.

    Technology:

    • Cutting-edge imaging facilities like PET CT scan, 3 Tesla MRI, and high-resolution CT scan.
    • Advanced robotic surgery systems (e.g., Da Vinci) for minimally invasive procedures.
    • Telemedicine services for remote consultations and patient monitoring.
    • A well-equipped cath lab for advanced cardiac procedures.
    • Modern radiation therapy equipment, including linear accelerators and brachytherapy units.

    Patient Services:

    • International patient services team to assist with travel arrangements, visa applications, and language translation.
    • Personalized care coordinators to guide patients through their treatment journey.
    • Comfortable and well-equipped patient rooms with various accommodation options.
    • Support services like nutrition counselling, physiotherapy, and psychological counselling.


    Max Super Speciality Hospital, Saket is one of the leading multispecialty hospitals in India, located in the heart of South Delhi. It is part of the Max Healthcare brand, which has a network of hospitals and healthcare facilities all over India.

    Here's a summary of the Max Super Speciality Hospital, Saket:

    • Established: 2006
    • Number of beds: 530+
    • Accreditations: JCI, NABH, NABL
    • Specialities: Over 38 specialities including Cardiology, Oncology, Neurology, Neurosurgery, Nephrology, Urology, Transplant services (Heart, Lung, Liver, Kidney, Bone Marrow), Metabolic and Bariatric Surgery, Obstetrics and Gynaecology, Aesthetics & Reconstructive Surgery, and many other ancillary medical services.

    Here are some of the reasons why Max Super Speciality Hospital, Saket is considered one of the best hospitals in India:

    • Advanced diagnostic and therapeutic technologies: The hospital is equipped with the latest technologies for diagnosis and treatment, including several first-in-India and Asia machines.
    • Team of experienced doctors: The hospital has a team of highly qualified and experienced doctors from various specialities.
    • Comprehensive care: The hospital provides comprehensive care for a wide range of medical conditions, from simple to complex.
    • Focus on patient care: The hospital is committed to providing quality care to its patients and has a patient-centric approach.

    Top EPS + RPA Ablation Surgeons in India

    1. Dr. Naresh Trehan


  • Gender: Male
  • Experience: Over 43 years
  • Designation: Chairman and Managing Director, Medanta - The Medicity, Gurugram
  • No. of Surgeries: 48,000+
  • Education:
    • Diplomate, The American Board of Cardiothoracic Surgery, USA, 1979
    • Diplomate, The American Board of Surgery, USA, 1977
    • M.B.B.S., K.G. Medical College Lucknow, 1968
  • Awards:
    • Padma Bhushan (2001)
    • Padma Shri (1991)
    • Dr. B.C. Roy Award (2002)
  • Career Highlights:
    • Senior Consultant, Cardio Vascular Surgery, Apollo Hospitals, Sarita Vihar (2007 - 2009)
    • Executive Director and Chief Cardiothoracic and Vascular Surgeon, Escorts Heart Institute and Research Institute (1988 - 2007)
    • Personal Surgeon to The President of India (1991 - present)
    • Honorary Consultant, Cromwell Hospital, London, UK (1994 - present)
  • Memberships:
    • Ex-President, International Society for Minimally Invasive Cardiac Surgery
    • Member, Society of Thoracic Surgeons, USA

    2. Dr. Vijay Dikshit



    • Gender: NA
    • Designation: Thoracic (Chest) Surgeon, General Surgeon
    • Experience Years: 50
    • Country: India
    • Location: Jubilee Hills, Hyderabad
    • Hospital: Apollo Hospitals, Jubilee Hills, Hyderabad

    Education:

    • MBBS from University of Lucknow, 1974
    • MS - General Surgery from University of Lucknow, 1977
    • MCh - Thoracic Surgery from the University of Lucknow, 1980

    Professional Memberships:

    • Medical Council of India (MCI)
    • Cardiological Society of India (CSI)

    Services Provided:

    • Dr Vijay Dikshit is a highly experienced Thoracic (Chest) Surgeon and General Surgeon practising at Apollo Hospitals in Jubilee Hills, Hyderabad. He has extensive expertise in a wide range of cardiac and thoracic surgical procedures.


    EPS + RPA Ablation Cost in India

    The cost of EPS + RPA ablation in India varies depending on the hospital, surgeon, and city. On average, the cost ranges from $3,000 to $7,000 USD. This includes pre-operative tests, the procedure itself, hospital stays, and follow-up consultations.



    EPS + RPA Ablation Success Rate in India

    The success rate of EPS + RPA ablation in India is high, with most hospitals reporting success rates between 85% and 95%. The success rate depends on the type of arrhythmia being treated, the patient's overall health, and the expertise of the medical team.


    How can HealthTrip assist with your treatment?

    If you're seeking EPS + RPA ablation treatment in India, let HealthTrip be your compass. We support you throughout your medical journey with the following:

    • Access to top doctors in 38+ countries and the largest health travel platform.
    • Partnerships with 1500+ hospitals, including Fortis, Medanta, and more.
    • Treatments in neuro, cardiac care, transplants, aesthetics, and wellness.
    • Post-treatment care and assistance.
    • Teleconsultations with leading doctors at $1/minute.
    • Over 61K patients served.
    • Access Top treatments and packages, such as Angiograms and many more.
    • Gain insights from genuine patient experiences and testimonials.
    • Stay updated with our medical blog.
    • 24/7 unwavering support, from hospital formalities to travel arrangements or emergencies.
    Hear from our satisfied patients

    Recovery and Post-Procedure Care

    After EPS and RPA ablation procedures, patients undergo:


    • Immediate monitoring for complications.
    • Bed rest to minimize bleeding risk.
    • Pain management as needed.
    • Fluid intake to flush out the dye.
    • Activity restrictions and medication adherence.
    • Follow-up appointments for monitoring and adjustments.
    • Lifestyle adjustments and emotional support for recovery.

    To sum up, the EPS + RPA Ablation procedures carried out in India demonstrate the nation's leadership in delivering state-of-the-art cardiac care. By emphasizing precision, effectiveness, and patient comfort, these procedures present a way to improve heart health and enhance the quality of life for individuals suffering from arrhythmias. India's ongoing advancements and dedicated medical expertise guarantee that the country continues to lead in cardiovascular innovation, catering to the needs of both domestic and international patients seeking superior medical outcomes.


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    FAQs

    EPS (Electrophysiology Study) and RPA (Radiofrequency Catheter Ablation) are advanced medical procedures used to diagnose and treat arrhythmias, which are irregular heartbeats. EPS maps the electrical activity of the heart, while RPA ablates, or destroys, the problematic tissue causing the arrhythmia.