Why It’s Done
What Is Catheter Ablation?
Catheter ablation is a treatment for cardiac arrhythmias.
What Is a Cardiac Arrhythmia?
A cardiac arrhythmia is an irregular or abnormal heart rhythm.
What Type of Rhythms Are Treated with This Procedure?
Normally, the heart’s impulses travel down an electrical pathway through the heart. The atria and ventricles work together, alternately contracting and relaxing to pump blood through the heart. The electrical system of the heart is the power source that makes this possible. Each electrical impulse causes the heart to beat.
Catheter ablation can be used to treat:
- AV Nodal Reentrant Tachycardia (AVNRT): An extra pathway lies in or near the AV node, which causes the impulses to move in a circle and reenter areas it already passed through.
- Accessory Pathway: Extra pathways can exist from birth that connect the atrium and ventricles. The extra pathway causes signals to travel back to the atrium, making it beat faster.
- Atrial Fibrillation and Atrial Flutter: Extra signals originating in different parts of the atrium cause the atria to beat rapidly or quiver.
- Ventricular Tachycardia: A rapid, potentially life-threatening rhythm originating from impulses in the ventricles. The rapid rate prevents the heart from filling with enough blood, and less blood is able to circulate through the body.
How Successful Is Catheter Ablation?
The type of catheter ablation performed and individual variables affect the success rate of the procedure. Please talk to your doctor about the success you can expect.
During ablation, a doctor inserts a catheter into the heart. A special machine delivers energy through the catheter to tiny areas of the heart muscle that cause the abnormal heart rhythm. This energy disconnects the pathway of the abnormal rhythm.
Ablation can also be used to disconnect the electrical pathway between the upper chambers (atria) and lower chambers (ventricles) of the heart. The type of ablation performed depends upon the type of arrhythmia.
Monitors Used During the Procedure
- Defibrillator/pacemaker/cardioverter: Attached to one sticky patch placed on the center of your back and one on your chest. This allows the doctor and nurse to pace your heart rate if it is too slow or to deliver energy to your heart if the rate is too fast.
- Electrocardiogram/EKG/ECG: Attached to several sticky electrode patches placed on your chest as well as inside your heart. Provides a picture on the monitors of the electrical impulses traveling through the heart.
- Blood pressure monitor: Connected to a blood pressure cuff on your arm. Checks your blood pressure throughout the procedure.
- Oximeter monitor: Attached to a small clip placed on your finger. Checks the oxygen level of your blood.
- Fluoroscopy: A large X-ray machine will be positioned above you to help the doctors see the leads on an X-ray screen during the procedure.
- Intracardiac ultrasound: Used throughout the procedure to view the structures of the heart and the catheter when it is in contact with the heart lining.
You will lie on a bed, and the nurse will start an intravenous line (IV) in your arm. The IV is used to deliver medications and fluids during the procedure.
A medication will be given through your IV to make you feel drowsy, and you may fall asleep.
Your neck, upper chest, arm, and groin will be cleansed with an antiseptic solution, and the catheter insertion site(s) will be shaved. Sterile drapes will be placed to cover you from your neck to your feet.
After you become drowsy, the doctor will numb the catheter insertion site(s) by injecting a medication.
The doctor will insert several catheters through a small incision into a large blood vessel, and it may be necessary to use both an artery and a vein. A transducer is inserted through one of the catheters so an intracardiac (inside your heart) ultrasound can be performed during the procedure. The ultrasound allows the doctor to view the structures of the heart.
You will feel a burning sensation when the doctor injects medication in the catheter insertion site.
You may feel your heart beating faster or stronger when the doctor uses the pacemaker device to increase your heart rate, and you may feel some discomfort or a burning sensation when the energy is applied.
It is important to remain quiet, keep very still, and avoid taking deep breaths. If you feel pain, ask your doctor or nurse to give you more medication.
The procedure may last up to 4 hours.
Some patients are sent home the same day, while others stay overnight in the hospital after the procedure.
Your doctor will determine if you need to stay overnight in the hospital.
After the procedure, the doctor will discuss the results of the procedure with you and your family.
You may need to take an antiarrhythmic medication to control abnormal heartbeats. Your doctor will give you the prescriptions and medication instructions you need.
Ask your doctor if you should continue taking your previous medications.
For your safety, a responsible adult must drive you home.
What Are the Possible Risks of the Procedure?
The catheter ablation procedure is generally very safe.
However, as with any invasive procedure, there are risks. Special precautions are taken to decrease these risks. Your doctor will discuss the risks of the procedure.
Before the Procedure
Do not discontinue any of your medications without first talking to your healthcare provider. Ask your doctor which medications you should stop taking and when to stop taking them.
- Stop taking Coumadin (warfarin) three days before your procedure
- Ask your doctor if you should take your other prescribed medication(s)
How to Prepare
- Do not eat or drink anything after midnight the night before the procedure
- Do not bring jewelry or valuables
After the Procedure
What to Expect After the Procedure
The doctor will remove the catheters and apply pressure to the insertion site to prevent bleeding. You will need to stay in bed 1 to 6 hours after the procedure to prevent bleeding and will need to keep your legs still during this time.
No stitches are needed, but small sterile bandage will cover the insertion site. Keep this area clean and dry. Tell your doctor or nurse right away if you have redness, swelling, or drainage at the procedure site. You can remove the bandage after you go home.
During your recovery, you will be placed on a telemetry monitor, which lets the nurses watch your heart rate and rhythm. Telemetry consists of a small box connected by wires to your chest with sticky electrode patches. The box displays your heart rhythm on several monitors in the nursing unit.
How You Will Feel After the Procedure
You may feel fatigue or chest discomfort during the first 48 hours after the procedure. Please tell your doctor or nurse if any of these symptoms are prolonged or severe.
You may experience skipped heartbeats or short episodes of atrial fibrillation after the procedure. After your heart has healed, these abnormal heartbeats should subside.