About the Cardiac Ablation Procedure
It's important to know what to expect before you undergo a cardiac ablation procedure as a treatment for arrhythmia (fast heartbeat). Be sure to talk to your doctor if you have any questions or concerns about this treatment.
What can I expect during cardiac ablation?
More than likely, your doctor has recommended that you undergo cardiac ablation (also called catheter or radiofrequency ablation) because other treatments for your arrhythmia have not given you the relief you want. In cardiac ablation, the electrode delivers a low-voltage, high-frequency current that removes the heart tissue responsible for the arrhythmia. Most people who have a cardiac ablation experience either:
- A long-term reduction in the number of episodes of arrhythmia and the severity of symptoms, or
- A return to normal heart rhythm
This means that, after successful cardiac ablation, you may be able to stop taking medication for controlling heart rate or rhythm, or you may be able to reduce the amount you take. Do not modify your medications without consulting your doctor. Cardiac ablation is considered safe and is not associated with a significant risk, so the chance of experiencing complications is very low. The electrophysiologist (EP) will discuss any particular risks with you before the procedure. The procedure always begins with an electrophysiology study.
How do I prepare for cardiac ablation?
Your doctor will tell you ahead of time whether to stop taking any of your medications. Do not modify your medications without consulting your doctor.
Usually, your doctor will tell you not to eat or drink for 6 to 8 hours before the test.
The area where the catheter will be inserted will be thoroughly cleaned and shaved. This is usually in the groin, but may be in the neck. You will receive a local anesthetic in that area.
You will be given a mild sedative. The catheters will then be inserted. You may initially feel some pressure at the site of insertion.
What happens during the cardiac ablation procedure?
Cardiac ablation is a nonsurgical procedure that involves 2 key stages: Mapping and Ablation.
Catheters (thin bendable tubes) are introduced into the heart via the circulatory system. One such catheter is special and is referred to as a 'mapping catheter'. This mapping catheter has a tiny electromagnetic sensor in its tip. This sensor communicates with the 3-D Electroanatomical Mapping and Ablation System in an EP lab and then by moving the catheter around the heart, the electrophysiologist creates a 3-D picture of the heart. The 3-D picture, or 'map', tells the EP detailed information about how the heart looks and where the electrical circuit is broken. The technology used is almost identical to the GPS technology used in navigation systems that we use every day in our cars.
Once the EP has created a 3-D map of the heart, he or she can maneuver the catheter to certain areas where the electrical circuit is broken. The EP then uses an electrical impulse and neutralizes these small areas of the heart tissue that generate and conduct abnormal electrical activity, giving rise to the irregular heart rhythm.
The whole procedure (including the EP study and mapping) may take several hours.
What happens after cardiac ablation?
Immediately after the procedure, the EP will remove the catheters and apply pressure to the insertion site to minimize or prevent bleeding; a bandage may be applied. It is important to remain still during this time and to not move or bend your leg.
Generally, you will stay in bed for several hours, or overnight, after the procedure for observation and go home the next day. Once you can get up and move around, you may feel stiff from lying still for so long.
At home, you will need to limit your activity for several days and avoid all strenuous physical activity. Most people can return to their normal routine within a few days. It is common to have a small bruise or walnut-sized lump where the catheter was inserted. You should contact your doctor immediately if the spot becomes warm, tender, painful, or swollen. You should also contact your doctor immediately if you experience fever, dizziness, or any other symptoms. Be certain to follow your doctor's instructions carefully regarding any medications and follow-up appointments.