If you have been diagnosed with a heart arrhythmia–a problem with the rate or rhythm of your heartbeat–your doctor may recommend a procedure called catheter ablation to improve your condition.
Also known as a cardiac ablation or radiofrequency ablation, this procedure guides a tube into your heart to destroy small areas of heart tissue that may be causing your abnormal heartbeat.
Not everyone with a heart arrhythmia needs a catheter ablation. It’s usually recommended for people with arrhythmias that can’t be controlled by medication or with certain types of arrhythmia from the upper chambers of the heart. Less commonly, it may be recommended for people with arrhythmia that begins in the lower chambers of the heart.
Catheter ablation can take anywhere from three to six hours. The procedure is usually done in an electrophysiology lab or operating suite where you will be monitored closely.
Before the procedure begins, you will be given intravenous medications to help you relax; some people even fall asleep. In some complex cases, you may be put to sleep by anesthesiologist.
After the medication has taken effect, your doctor will numb an area on your arm, neck, or groin and make a small hole in your skin. Then, the doctor will guide a thin guide wire and a small catheter to your heart through blood vessels. A special dye is used to help your doctor place the catheter in the right spot. In some cases, your doctor may place several catheters, which are used to help guide the procedures. At times, an intravascular ultrasound catheter may also be used to help the doctors take images of your heart during the procedure.
After the catheter has been placed correctly, electrodes at the end of the catheter are used to stimulate your heart and locate the problem areas that are causing the abnormal heart rhythm. Then, the doctor will use mild radiofrequency heat energy to destroy or “ablate” the problem area. This area is usually quite small, about one-fifth of an inch. Other types of ablation techniques may be used, such as cryoablation, which uses very cold temperatures to destroy the problem area. Your doctor will decide which type of ablation therapy is most appropriate for you. Once the tissue is destroyed, the abnormal electrical signals that created the arrhythmia can no longer be sent to the rest of the heart.
Most people do not feel pain during the procedure. You may sense mild discomfort in your chest. After the ablation is over, your doctor will remove the guide wire and catheter from your chest.
After the catheter ablation, you will probably need to lie still for 4-6 hours to decrease the risk of bleeding. Medical staff may apply pressure to the site where the catheter was inserted. Special machines will be used to monitor your heart as you recover. Some people can go home on the same day as the ablation, but others will stay in the hospital for one or more nights.
Recovery from catheter ablation is usually fairly straightforward. In the days following the procedure, you may experience mild symptoms such as an achy chest and discomfort or bruising in the area where the catheter was inserted. You might also notice skipped heartbeats or irregular heart rhythms. Most people can return to their normal activities within a few days.
Contact your doctor immediately if you have unusual pain or swelling, excessive bleeding, or consistent irregularities in your heartbeat.
Depending on the type of arrhythmia being treated, catheter ablation can have a success rate of more than 90 percent, but some people may need to have the procedure again or other treatments for heart arrhythmias. Your doctor may want you to remain on medications to help control your heartbeat.
After your catheter ablation, be sure to follow all instructions from your doctor, especially regarding follow-up visits, medication schedules, and safe levels of physical activity.