Cardiac Ablation Procedure
Overview
Cardiac ablation treats irregular heart rhythms, also known as arrhythmias. The procedure uses either heat or cold to make small scars on the heart, which block abnormal electrical signals.
| Method | Purpose | Common Tools |
|---|---|---|
| Heat or cold ablation | Block faulty signals | Catheters, surgical |
Doctors usually perform this process with catheters—thin tubes they insert through a blood vessel. In rare cases, surgeons may perform ablation during heart surgery.
Types
Common types of ablation include catheter-based procedures such as radiofrequency and cryoablation, as well as surgical approaches and hybrid techniques like the maze procedure.
Reasons for Cardiac Ablation
Doctors use cardiac ablation to fix problems with the heart’s rhythm, called arrhythmias. This treatment helps when the heart beats in an abnormal pattern, such as too fast, too slow, or unevenly.
Arrhythmias include conditions like atrial fibrillation (AFib), atrial flutter, ventricular arrhythmia, inappropriate sinus tachycardia, and paroxysmal atrial fibrillation. Some of the main reasons for this procedure include:
- Medicines don’t control arrhythmias or cause unwanted side effects.
- The person has arrhythmias that respond well to ablation, such as Wolff-Parkinson-White syndrome, supraventricular arrhythmias, accessory pathways, or atrioventricular nodal reentrant tachycardia.
- There is a risk of serious health issues, such as sudden cardiac arrest or heart failure.
Table: Common Conditions Treated by Cardiac Ablation
| Arrhythmia Type | Examples |
|---|---|
| Supraventricular Arrhythmias | AVNRT, Wolff-Parkinson-White, AFib, flutter |
| Ventricular Arrhythmias | Ventricular tachycardia |
| Specialized Pathways | Accessory pathways, cavotricuspid isthmus |
Doctors target small areas of heart tissue to manage or stop these irregular heartbeats, which helps reduce symptoms and lowers the risk of complications.
Risks
Cardiac ablation can lead to several possible complications. Some of the main risks include bleeding and infection at the spot where the catheter goes in. The procedure can damage blood vessels or heart valves.
A new irregular heartbeat can start, or a slow heart rate might develop, which sometimes requires a pacemaker. Other possible concerns are:
- Blood clots in the legs or lungs
- Stroke or heart attack
- Narrowing of veins between the lungs and heart
- Kidney damage from contrast dye used during the procedure
Symptoms may return after treatment, especially in people with structural heart disease.
Getting Ready for the Procedure
To prepare for cardiac ablation, patients often have tests so the electrophysiologist or cardiologist can check heart health. Most people will need to stop eating and drinking starting the night before. Follow medicine instructions carefully; sometimes changes are needed before anesthesia.
Key Steps
- Complete all heart tests as directed.
- Do not eat or drink after the set time.
- Check with the care team about which medications to take or stop.
- Arrive with someone who can take you home after the procedure.
What You Should Anticipate
Getting Ready
Before cardiac ablation, patients come to the hospital where a care team member sets up an IV, usually in the arm or hand. The team gives medicines for relaxation, called sedation, but the level depends on the person’s health and the type of heart rhythm issue.
Some people only need mild sedation and stay awake, while others receive deeper medicine and enter a sleep-like state known as general anesthesia. The care team makes these preparations in settings like an electrophysiology lab, where advanced mapping—such as electroanatomic mapping—improves the accuracy of the procedure.
What Happens in the Procedure
During the procedure, doctors use thin tubes called catheters, which they thread through a blood vessel in the groin, and sometimes in the neck or shoulder, to reach the heart. They send a special dye, called contrast, through the tube so blood vessels appear clearer on X-rays.
Sensors on the catheters send and record electrical signals, guiding the care team to the part of the heart causing the irregular beats. The team maps the heart’s electrical system as a key part of the process.
The doctor then uses either heat (radiofrequency energy) or extreme cold (cryoablation) to create very small scars. These scars block the pathways that allow abnormal heart rhythms.
Patients are typically comfortable, but if any pain or trouble breathing occurs, they should alert the care team immediately. Some people who have existing devices like a pacemaker may need special care during this time. Key tools and concepts used during the procedure:
| Tool/Concept | Purpose |
|---|---|
| Catheter | Device to access the heart |
| Contrast Dye | Helps with X-ray visibility |
| Electroanatomic Mapping | Maps heart’s electrical activity |
| Radiofrequency or Cryoablation | Creates scars to stop arrhythmia |
The Recovery Phase
After cardiac ablation, the care team watches people closely in a recovery area for a few hours. Depending on their progress and health, some people go home the same day while others stay overnight.
Most people feel only mild soreness, and it generally goes away within a week. Lifting heavy objects or doing strenuous work should be avoided for about a week, but many can get back to regular routines in a few days.
Outcomes
After cardiac ablation, many people notice a better quality of life and improved heart rhythm. However, irregular heartbeat can sometimes recur. In these cases, doctors may repeat the procedure or use other treatments. Some patients might still require medications for their heart.
