Cardiac ablation is used for long-lasting treatment for many types of arrhythmias. The procedure locates and neutralizes, or ablates, the specific cells in the heart muscle that are causing an arrhythmia.
Arrhythmias are caused by a trouble in the heart’s normal electrical system. During a cardiac ablation procedure, the source of the trouble is found and eliminated. This restores the normal pathways of your heart and allows it to beat normally.
A cardiac ablation procedure is performed by a cardiac specialist called an electrophysiologist or EP. A family doctor or cardiologist may refer you to an EP doctor for a cardiac ablation procedure.
How to Prepare
Your healthcare provider will give you specific instructions about preparing for your ablation procedure prior to admission to the hospital. Follow these instructions carefully.
Your healthcare provider determines whether you should continue or stop certain medications, if you should avoid eating or drinking in the hours before the procedure and what to expect when you check into the hospital.
You may be admitted to the hospital the same day of the ablation. You may undergo preliminary blood tests, an X-ray, and ECG. You may go home that night, or stay at the hospital overnight.
Tell your doctor if you:
- Are allergic to seafood
- Have had a bad reaction to contrast material or iodine in the past
- Are taking Viagra
- Might be pregnant
It is important for you to let the healthcare provider know all the medications you are taking. It is also important for your healthcare provider to know if you have allergies to any medications or to X-ray dye.
What to Expect
Specially trained EP nurses and technicians work with your EP doctor as a team to provide care. You will be brought to the electrophysiology laboratory, a special room in the hospital with testing equipment and staff for the procedure.
An intravenous (IV) line will be started in your arm and you will be given medicine to help you relax and get sleepy. This is called conscious sedation, which means you remain aware of your surroundings and are able to talk to the staff, but you should not feel any pain.
Your healthcare provider will clean, shave and numb the site where catheters will be inserted into your veins. This is typically done in one or both sides of your groin, or your neck in order to access the heart.
During the procedure, several thin tubes (catheters) are inserted into a vein in your leg, usually in your groin area (on the inside of your legs). Your doctor will gently push the catheters all the way into your heart.An X-ray machine (fluoroscope) provides images of your heart during the procedure to help the doctor accurately position each catheter.
Before the doctor can perform the actual ablation, the specific area of the heart that causes the arrhythmia must be identified. To do this, an electrical "map" of the heart is created. This is done by recording the electrical activity of the heart while an arrhythmia is active. You may experience symptoms from your arrhythmia during this time, but otherwise you should be resting comfortably.
Once the doctor has located the source of your arrhythmia, a special ablation catheter will be delivered to your heart. The tip of the ablation catheter is placed next to the heart tissue in the targeted area.
Radio frequency (RF) energy is delivered through the tip of the catheter. This may eliminate the problem cells, restoring the normal electrical pathways of the heart. This allows the heart to beat normally.
There are two types of RF ablation - temperature control and fluid cooled.
Depending on the complexity of the arrhythmia, the procedure may take an hour, or several hours. If you experience any chest discomfort or pressure during the procedure, you should tell a nurse. Ask any questions you have at any time during the procedure. The lab staff will do everything possible to keep you comfortable.
What Happens Next
The doctor will visit you to discuss the ablation procedure and the results of treating the arrhythmia. At this time, the doctor will also discuss other things you should do or treatments you may need, if any.
Most people are able to leave the hospital the same day though in some cases an overnight stay may be necessary. You must have someone available to drive you home and stay with you that evening.
Recovery from a catheter ablation procedure is usually quick. Many people are able to resume most of their normal activities 24 hours after the procedure. As the insertion site heals, some people experience bruising and feel a small, hard lump. This is normal and will go away in a few days.
If any of the following are experienced, it is very important to call the healthcare provider.
- Bleeding at the insertion site
- Increased pain
- Any complaint of chest pain
- Shortness of breath
- Feeling cold, have swelling, or numbness on the arm or leg of the insertion site
- The bruising or lump at the insertion site gets larger
- Fever over 100° F
- Return of arrhythmia symptoms