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What is cardiac ablation?

Cardiac ablation is a procedure used to treat heart arrhythmia, such as rapid or irregular heartbeat. It is the procedure of choice if medication or electrical cardioversion treatments were not an option or were not effective. 

The types of cardiac ablation that are performed include:

  • Radiofrequency ablation (also known as catheter ablation or transcatheter approach) – When an electrophysiology study reveals an arrhythmia, radio waves can be used to silence the abnormal activity. A catheter with an electrode at its tip is inserted into the heart through a vessel in the groin or arm and moved to the site where the problem is occurring. Very high frequency (yet virtually painless) radio waves heat the tissue until the site is destroyed (electrocautery). It's done under mild sedation with local anesthesia, and patients are sometimes given anti-arrhythmic drugs. Because it's minimally invasive and low-risk, the procedure is successful in about 90 percent of patients, and less recovery time is needed.
  • Laser ablation – This minimally invasive procedure involves a tiny incision through which the laser ablation probe is placed to deliver laser energy to heat the diseased regions. This focused approach eliminates damage to healthy tissue.  
  • Cryoablation – This is a minimally invasive procedure involving the freezing of abnormal tissue in the heart, lessening radiation exposure and the complexity of the procedure. A catheter is inserted into the heart through a vessel in the groin or arm, and moved to the site where the problem is occurring. An ultra-cold substance is then applied, freezing the tissue and destroying the site.

Why it's done

Cardiac ablation is performed when: 

  • Medicine doesn’t control your irregular heartbeat, or you can’t tolerate the medicine needed to control the arrythmia
  • You are diagnosed with atrial fibrillation or Wolff–Parkinson–White syndrome
  • You have abnormal electrical activity that puts you at risk for life-threatening arrhythmias, such as ventricular fibrillation and sudden cardiac death

Risks

There are few risks with cardiac ablation. Fewer than 5 percent of people who have the procedure develop any problems. The most common problems result from the use of catheters – long, thin tubes doctors insert into your arteries or veins. Inserting the tubes can occasionally damage your blood vessel or cause bleeding or infection. These problems are rare.

What to expect

A cardiac electrophysiologist (a doctor trained in the electrical system of the heart) performs the procedure, which usually takes two to four hours. They will move several catheters (long flexible tubes) slowly toward your heart. The doctor watches the movement of the catheters using an X-ray type of camera above the procedure table, then will stimulate your heart to locate the abnormal area. A machine will send energy (heat, laser or cryo) targeted to the exact area. The physician destroys the malfunctioning tissue, scarring the area to prevent it from sending incorrect electrical signals that speed up your heart rate. You may feel your heart beat differently or faster than usual, and may feel lightheaded, discomfort or burning in your chest.

Afterward, you will be expected to lie still for four to six hours in a recovery room. Some patients go home that same day where others may be required to stay overnight or a few days. During this time, you may feel tired or dazed as you recover from the sedative. You may have some pressure bandages covering the catheter incision site.

You may need to make arrangements for transportation the day of the procedure since your doctor may advise against driving.

How to prepare

Prior to the surgery, your doctor will do electrical mapping of your heart to see where the unusual activity is occurring. They will discuss the risks, benefits and choices with you.

Recovery

Recovery from catheter ablation is quick, although you may feel some soreness at the site of the catheter. Your doctor will give you instructions, if needed. Most people will return to their normal activity within a few days.

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