Ablation is a procedure that involves removal of surface with the help of chemical or laser. Cardiac ablation involves ablation of cardiac tissues, and is a minimally invasive procedure done with the help of a bundle of catheters. The procedure depends upon physical condition and malaise faced by the patient. Cardiac ablation is used to treat conditions of cardiac arrhythmias, viz. tachycardia (supraventricular/atrial), atrial fibrillation (paroxysmal/intermittent), atrial flutter and WPW (Wolff-Parkinson-White) syndrome. Cardiac arrhythmia and similar disorders arise as a result of irregular signaling of cardiac tissues. These areas, that cause such chaotic movements, are removed by ablation with the help of special bundle of catheters. The tissue that underwent ablation regenerates in a period of time and is replaced by healthier ones, in some rare cases, pacifiers/ regulators may also be introduced.
The surgery is minimally invasive and can be done with local anesthesia, at the point of catheter insertion, which are either located in the femoral vein, internal jugular vein, or subclavian vein. Mobile X-ray CT scanners are used to guide the catheter to the area of ablation. Ablation procedures have seen a great success rate in recent years of cardiac surgeries; they have tremendously reduced the overall number of open heart surgeries. Patients nowadays can even be sent on the same day of the procedure. The success rate of atrial flutter and supraventricular procedures, according to some studies, it is as high as 95% (with +/- 3%). This is a significant upheaval of the success for these procedures, which were earlier done with high uncertainties.
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Cardiac ablations are performed by trained cardiologist, specialist in electrophysiology. The requirement of a catheter lab may or may not be mandatory, depending upon the regulation or hospital policies. Catheter designs and their respective procedure methodology however require approval of regulatory bodies like the FDA and others. The design and approval for new arterial fibrillation (AF) procedures, that uses different entry point in the body and a novel device, are under development, as previous procedures showed limited success.
Companies like Articure and Medtronic have been offering cardiac ablation systems since long, but excluding labels for AF procedures, as feasibility studies are yet to be carried out in the U.S. Another company called Mount Sinai, has been developing the use of visually aided catheter systems for AF. With approval for these procedures as well, we may see the innovation of a universal cardiac ablation systems in the future. In recent times one can observe mutations and irregularities in the normal gene pool. With increasing population, the number of people suffering from cardiac irregularities is bound to increase. Also the advanced diagnostic techniques and easy availability of healthcare facilities leads to increasing frequency of procedures.
The restrictions set by regulatory authorities at present are the only restraint to the growth of these devices. Besides these, the chances of side effect remain few. Some side effects are: stroke, esophageal injury, chemical allergies, or in very rare cases, death of complete heart is observed in less percentage of the total population. The cost of equipment and procedure is high, but are comparatively less than open heart surgeries. With increased participation of Asian players, the prices are set to decrease and become more affordable in future.
Globally, the North American region is currently the largest by sales volume, followed by Europe. The Asian market has the highest potential in future, owing to rising population. Also, increasing geriatric population in these regions is one of the key factors supporting the growth of this market.
Some of the major players in this industry are; Medtronic Inc., Articure Inc., Mount Sinai Corp., Boston Scientific, St Jude Medical, Alcon Laboratories Inc. amongst others.