Cardiac ablation
Hot or cold energy applied to the heart can correct rapid or erratic heartbeats (arrhythmias). Know when you might need this treatment and the risks.
Overview
Cardiac ablation uses heat or cold energy to create tiny scars in the heart to block irregular electrical signals and restore a typical heartbeat. The procedure is used to correct heart rhythm problems (arrhythmias).
Cardiac ablation is most often done using thin, flexible tubes called catheters inserted through the veins or arteries. Less commonly, ablation is performed during cardiac surgery.
Cardiac ablation is a procedure that scars tissue in your heart to block irregular electrical signals. It is used to treat heart rhythm problems (arrhythmias). Long flexible tubes (catheters) are threaded through blood vessels to the heart. Sensors on the tips of the catheters transmit heat or cold energy to destroy (ablate) the tissue. This illustration shows a type of cardiac ablation called pulmonary vein isolation.
Why it's done
Cardiac ablation is a procedure that's used to correct heart rhythm problems.
When the heart beats, the electrical signals that cause the heart to squeeze (contract) must follow a specific pathway through the heart. Any disruption in the signaling pathway can trigger an irregular heartbeat (arrhythmia).
Depending on the type of heart rhythm problem, cardiac ablation may be one of the first treatments. Other times, it's done when other medicines or treatments don't work.
Your health care provider may recommend cardiac ablation if you:
- Have tried medications to treat an arrhythmia without success
- Have had serious side effects from medications to treat arrhythmias
- Have certain types of arrhythmias that respond well to ablation, such as Wolff-Parkinson-White syndrome and supraventricular tachycardia
- Have a high risk of complications from arrhythmias, such as sudden cardiac arrest
Risks
Possible cardiac ablation risks include:
- Bleeding or infection at the site where the catheter was inserted
- Blood vessel damage
- Heart valve damage
- New or worsening arrhythmia
- Slow heart rate that could require a pacemaker to correct
- Blood clots in the legs or lungs (venous thromboembolism)
- Stroke or heart attack
- Narrowing of the veins that carry blood between the lungs and heart (pulmonary vein stenosis)
- Damage to the kidneys from contrast used during the procedure
- Death in rare cases
Discuss the risks and benefits of cardiac ablation with your health care provider to understand if this procedure is right for you.
How you prepare
Your health care provider may order several tests to get more information about your heart condition before your cardiac ablation.
You'll need to stop eating and drinking the night before your procedure. Your care provider will tell you how or if you should continue any medications before a cardiac ablation.
What you can expect
Before
Cardiac ablation is done in the hospital. A specialist will insert an IV into your forearm or hand and give you a medication called a sedative to help you relax.
The amount of sedation needed for the procedure depends on your specific arrhythmia and other health conditions. You may be being fully awake or lightly sedated, or you may be given general anesthesia (fully asleep).
During
The health care provider inserts the catheter through a blood vessel into your heart. More than one catheter is often used. The catheters may be inserted through a blood vessel in your groin (most common), shoulder or neck (less common).
Dye (contrast) may be injected through the catheter to help blood vessels show up more clearly on X-ray images.
Sensors on the tip of the catheter send electrical impulses and record your heart's electricity. Your health care provider uses this information to identify the area that is causing your arrhythmia and to decide where to apply the ablation. This part of the procedure is called an electrophysiology (EP) study.
One of the following ablation techniques is used to create small scars in your heart and block the irregular heart rhythms:
- Heat (radiofrequency energy)
- Extreme cold (cryoablation)
You may feel some minor discomfort when the catheter is moved into your heart and when energy is being delivered. If you have severe pain or shortness of breath, let your health care provider know.
After
Cardiac ablation usually takes three to six hours to complete (but it can vary a lot based on the type of arrhythmia you have).
Afterward, you'll be taken to a recovery area for a few hours where care providers will closely monitor you. Depending on your condition, you may go home the same day or spend the night in the hospital. Plan to have someone else drive you home after your procedure.
Some people feel a little sore after the procedure. The soreness shouldn't last more than a week. Most people can return to their daily activities within a few days after having cardiac ablation. Avoid heavy lifting for about a week.
During cardiac ablation, a long flexible tube (catheter) is passed through a blood vessel in order to reach your heart. More than one catheter is often used. The catheter may be inserted in your groin, your shoulder or your neck.
Results
Most people see improvements in their quality of life after cardiac ablation. But there's a chance that the irregular heartbeat may return. If this happens, the procedure may be repeated or you and your health care provider might consider other treatments. Depending on your type of arrhythmia, you may still need to take heart medication after a cardiac ablation.