Cardiac Ablation

What is it?

Ablation is the use of heat to vaporize abnormal tissue or restore normal functioning. Catheter ablation is a procedure in which a thin, flexible tube is inserted into a vein in the upper thigh and threaded through the bloodstream to the abnormal area. In cardiac care, the catheter is guided to the heart where radiofrequency energy (radio waves) is applied through the catheter. Catheter ablation is most often used in cardiac care to treat atrial fibrillation and some other types of arrhythmia or heart rhythm disorders.

Why is it important?

Your doctor has prescribed an ablation because you have an abnormal heart rhythm that requires treatment. An ablation is likely to control your abnormal rhythm. Catheter ablation is recommended as treatment for those heart rhythm disorders in which:

• An abnormal pathway short-circuits the normal electrical system of the heart, causing a fast heartbeat.
• The heart can "race" for a few seconds to a few hours
• A person can have symptoms of palpitations, chest pounding, dizziness, lightheadedness, and even fainting.

Before the procedure

• You will be admitted to the hospital the day before, or the morning of, your procedure. You may have blood tests, x-rays and an EKG (electrocardiogram). Your heart rhythm may be monitored throughout the time you are in the hospital.
• Do not to eat or drink anything for six hours before the procedure. You may take sips of water with any medications the doctor advises you to continue.
• If you are taking heart rhythm medications (antiarrhythmics), they should be stopped at least 72 hours before the procedure on the advice of your doctor.
• The doctor will explain the procedure, and then ask you to sign a consent form. An intravenous (IV) line will be placed in a vein in your arm. You'll be taken to the EP lab about 30 minutes before your scheduled procedure time.

During the Procedure

• The areas where the catheters are to be inserted will be shaved and scrubbed with an antiseptic solution.
• Catheters will be inserted into veins in your neck, arm and groin (and possibly into arteries in your groin) and threaded into your heart under x-ray guidance.
• Some abnormal pathways located on the left side of the heart may need to be reached through a different technique. If this is necessary, your doctors will discuss it with you.
• After positioning the catheters in different areas of your heart, the doctors will try to start your abnormal heart rhythm. This helps them find the exact area of the defective heart tissue (where the abnormal rhythm comes from).
• The special catheter is applied to the targeted area of the heart to destroy the defective tissue. This is done with radiofrequency energy or electrical current.
• The doctors will then try repeatedly to start your abnormal rhythm, to check the effectiveness of the procedure.
• Your catheter ablation will usually last 2-4 hours.

After the Procedure

• You will be taken to the recovery room for about two hours if you were asleep for the procedure. Then you'll go back to your room, where your heart rate, blood pressure and dressings will be checked often by your nurse. Tell the nurse right away if you feel any discomfort or notice any bleeding.
• You'll be asked to lie flat in bed for about six hours, and to keep your arm and leg straight to prevent any bleeding. The nurse or your family can help you with meals during this time. Your doctors will discuss the results of the procedure with you and your family.
• Once the dressing is removed, tell your nurse if you notice any drainage, swelling, or tenderness at the catheter insertion site.
• A thin tube may remain in your neck after the procedure. This will be used for inserting a catheter during the follow-up Electrophysiology study that is usually done the next day.