Cardiac Ablation

Cardiac ablation is a procedure to disable a small amount of heart tissue in very specific places. The heart has many electrical connections. Sometimes these connections are abnormal and can cause the heart to beat very fast or irregularly. By disabling some of the problem areas, heart rhythm can be improved or made normal. Ablation is done for people who:

  • Have Wolff-Parkinson-White syndrome.  

  • Have other fast heart rhythms (tachycardia).  

  • Have taken medicines for an abnormal heart rhythm (arrhythmia) that resulted in:  

  • No success.  

  • Side effects.  

  • May have a high-risk heartbeat that could result in death.  

LET YOUR HEALTH CARE PROVIDER KNOW ABOUT:

  • Any allergies you have or any previous reactions you have had to X-ray dye, food (such as seafood), medicine, or tape.  

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.  

  • Previous problems you or members of your family have had with the use of anesthetics.  

  • Any blood disorders you have.  

  • Previous surgeries or procedures (such as a kidney transplant) you have had.  

  • Medical conditions you have (such as kidney failure).  

RISKS AND COMPLICATIONS

Generally, cardiac ablation is a safe procedure. However, as with any procedure, complications can occur. Possible risks and complications include:

  • Increased risk of cancer. Depending on how long it takes to do the ablation, the dose of radiation can be high. 

  • Bruising and bleeding where a thin, flexible tube (catheter) was inserted during the procedure.  

  • Bleeding into the chest, especially into the sac that surrounds the heart (serious).

  • Need for a permanent pacemaker if the normal electrical system is damaged.  

  • The procedure may not be fully effective, and this may not be recognized for months. Repeat ablation procedures are sometimes required.

BEFORE THE PROCEDURE

  • Follow any instructions from your health care provider regarding eating and drinking before the procedure.  

  • Take your medicines as directed at regular times with water, unless instructed otherwise by your health care provider. If you are taking diabetes medicine, including insulin, ask how you are to take it and if there are any special instructions you should follow. It is common to adjust insulin dosing the day of the ablation.  

PROCEDURE

  • An ablation is usually performed in a catheterization laboratory with the guidance of fluoroscopy. Fluoroscopy is a type of X-ray that helps your health care provider see images of your heart during the procedure.  

  • An ablation is a minimally invasive procedure. This means a small cut (incision) is made in either your neck or groin. Your health care provider will decide where to make the incision based on your medical history and physical exam.

  • An IV tube will be started before the procedure begins. You will be given an anesthetic or medicine to help you relax (sedative).

  • The skin on your neck or groin will be numbed. A needle will be inserted into a large vein in your neck or groin and catheters will be threaded to your heart.

  • A special dye that shows up on fluoroscopy pictures may be injected through the catheter. The dye helps your health care provider see the area of the heart that needs treatment.

  • The catheter has electrodes on the tip. When the area of heart tissue that is causing the arrhythmia is found, the catheter tip will send an electrical current to the area and "scar" the tissue.  Three types of energy can be used to ablate the heart tissue:  

  • Heat (radiofrequency energy).  

  • Laser energy.  

  • Extreme cold (cryoablation).  

  • When the area of the heart has been ablated, the catheter will be taken out. Pressure will be held on the insertion site. This will help the insertion site clot and keep it from bleeding. A bandage will be placed on the insertion site.  

  • An ablation procedure can take 1–6 hours to complete.

AFTER THE PROCEDURE

  • After the procedure, you will be taken to a recovery area where your vital signs (blood pressure, heart rate, and breathing) will be monitored. The insertion site will also be monitored for bleeding.  

  • You will need to lie still for 4–6 hours. This is to ensure you do not bleed from the catheter insertion site.  

  • If your blood pressure and heart rate are stable and no bleeding occurs at the insertion site, you may go home the same day as your procedure.  

  • If complications occur or your health care provider feels you should be watched, you may need to stay in the hospital overnight.