Cardiac ablation is a procedure performed by a cardiologist, a doctor who specializes in heart problems. It involves threading catheters (long, flexible wires) through a blood vessel and into your heart. Using electrodes, the cardiologist delivers a safe electrical pulse to your heart muscle to treat an irregular heartbeat.
Sometimes, your heart may beat too fast, too slowly, or unevenly. These heart rhythm problems are called arrhythmias. Some arrhythmias can be treated using cardiac ablation.
According to the University of Alabama at Birmingham’s Heart and Vascular Center, more than 14 million Americans have a heart rhythm problem (UAB). Many people living with arrhythmias don’t have dangerous symptoms or need medical attention. Others live normal lives with medication.
Patients who can see improvement from cardiac ablation include those who:
- have arrhythmias that don’t respond to medication
- suffer bad side effects from arrhythmia medication
- have a specific kind of arrhythmia that tends to respond well to cardiac ablation
- are at a high risk for sudden cardiac arrest or other complications
Cardiac ablation may be helpful for patients with these specific types of arrhythmia:
- AV nodal reentrant tachycardia (AVNRT): a very fast heartbeat caused by a short circuit in the heart
- accessory pathway: a fast heartbeat due to an abnormal electrical pathway connecting the heart’s upper and lower chambers
- atrial fibrillation and atrial flutter: an irregular and fast heartbeat starting in the heart’s two upper chambers
- ventricular tachycardia:a very fast and dangerous rhythm starting in the heart’s two lower chambers
Your doctor may order tests to record your heart’s electrical activity and rhythm. Your doctor may also ask about any other conditions you have, including diabetes or kidney disease, to avoid possible complications. Patients who are pregnant should not have cardiac ablation because the procedure involves radiation.
Your doctor will probably tell you not to eat or drink anything after midnight the night before the procedure. You may also need to stop taking medications that can increase your risk of excessive bleeding, including aspirin and Warfarin.
Cardiac ablations take place in a special room known as an electrophysiology laboratory. Your healthcare team may include a cardiologist, a technician, and a nurse. The procedure typically takes between three and six hours to complete.
You’ll get medication through an intravenous (IV) line in your arm that will make you drowsy. You may fall asleep. Equipment will monitor your heart’s electrical activity.
Your doctor will clean and numb an area of skin on your arm, neck, or groin. Next, he or she will thread a series of catheters through a blood vessel and into your heart. You will be injected with a special contrast dye to help the doctor see areas of abnormal muscle in your heart. Then, the cardiologist will use a catheter with an electrode at the tip to direct a burst of radiofrequency energy. This electrical pulse will destroy small sections of abnormal heart muscle to correct your irregular heartbeat.
The procedure may feel a bit uncomfortable. If it becomes painful, make sure to ask your doctor or nurse for more medication.
Afterward, you will go to a recovery room where you will lie still for four to six hours to help your body recover. Nurses will monitor your heart rhythm during recovery. Patients may go home on the same day or may need to stay in the hospital overnight.
Risks include bleeding, pain, and infection at the catheter insertion site. More serious complications are rare, but may include:
- blood clots
- damage to your heart valves or arteries
- fluid build-up around your heart
- heart attack
You may be tired and experience some discomfort during the first 48 hours after the test. Follow your doctor’s instructions about wound care, medications, physical activity, and follow-up.
Some patients may still have short episodes of uneven heartbeat after cardiac ablation. This is normal as tissue heals and should go away over time.
Your doctor will tell you if you need any other procedures, including pacemaker implantation, especially to treat complex heart rhythm problems.