Ablation Treatment of Heart Rhythm Problems

What is ablation?

Ablation is a procedure for treatment of abnormal heart rhythms. It is done to block abnormal electrical pathways in the heart. This helps stop abnormal heart rhythms.

This procedure most often uses radio waves for the ablation and is called radiofrequency ablation. Another common term is cardiac ablation.

When is it done?

Ablation may be done when abnormal pathways in the heart carry electrical signals that cause the heart to beat too fast. Drugs may be used to treat abnormal heartbeats. However, for some people, the drugs don’t work well or are not the best way to treat the problem. It may be better to block the part of the heart's electrical system that has an abnormal pathway. Ablation may successfully treat the problem, and medicine may no longer be needed.

Examples of heart rhythm problems that may be treated with ablation include Wolff-Parkinson-White syndrome, supraventricular tachycardia, atrial fibrillation, and ventricular tachycardia.

How do I prepare for this procedure?

• Talk with your healthcare provider about what medicines you should take before the procedure. Your provider may prescribe medicine to prevent blood clots from forming during the procedure. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.
• Plan for your care and a ride home after the procedure. Also plan for your recovery at home.
• Tell your provider if you have had any kidney problems or reactions to iodine-containing foods or chemicals, such as seafood or X-ray contrast dye.
• Your provider will ask you not to eat or drink anything after midnight the night before the procedure.

What happens during the procedure?

You will be given medicine to keep you from feeling pain during the procedure. Usually a local anesthetic is given to numb the area where the catheter is inserted, along with medicine to help you relax. Sometimes a general anesthetic is used. The general anesthetic will put you in a deep sleep.

A catheter, which is a small tube, will be put through a vein in your groin. X-rays will be used to guide the tip of the catheter to the right place in your heart. Your healthcare provider will use the catheter to record electrical signals in your heart and to find the area in the heart that is causing the problem. The tip of the catheter will be aimed at the abnormal area and energy will be sent from the catheter tip to that part of your heart. Your heart will form a small scar in this area, and the scar will keep the abnormal path from being used again.

Different kinds of energy may be used to block the abnormal path:

• radio waves
• laser
• extreme cold.

Your provider will check the electrical activity in your heart again before removing the catheter. The procedure may last several hours.

What happens after the procedure?

You will go back to your hospital room and rest in bed for a few hours. You will most likely be able to go home the next day. In some cases, you may be able to go home the day you have the procedure. You can usually go back to your normal activities within a day or two. Your healthcare provider may ask you to avoid some activities, such as heavy lifting, for a short period of time.

Some people do not need further treatment after the ablation. Sometimes the heart rhythm problem comes back and the ablation may need to be done again.

You should ask your healthcare provider what other steps you should take and when you should come back for a checkup.

What are the benefits of the procedure?

Ablation treatment destroys abnormal electrical pathways in the heart. This can help you have normal heart rhythms again.

What are the risks of the procedure?

There are some risks with this procedure.

• The catheter may cause bleeding where it is put into the vein.
• The catheter might hurt the heart muscle or esophagus.
• Ablation sometimes destroys more heart tissue than intended and causes another heart rhythm problem called a block. If you develop a block, you may need to have a pacemaker implanted in your chest.
• Blood clots may break off and cause a stroke.
• Sometimes the ablation is done near the lungs and may cause breathing problems or coughing up blood.

Ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You have chest pain.
• You feel lightheaded or faint.
• You have constant or worsening pain or numbness in your arm or leg.
• You have a fever.
• You have shortness of breath.
• Your arm or leg becomes blue and cold.
• You have bleeding, a lot of bruising, or a lot of swelling where the catheter was inserted.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.