Catheter Ablation

Your Care Explained > Tests and Procedures : Catheter Ablation

When men can’t tolerate antiarrythmics or do not respond adequately to them, catheter ablation is often recommended. Our research shows that the procedure is just as effective in women as in men.

The only exception for women is if you’re pregnant, or think you are, we’ll postpone the procedure until after your baby is delivered. We don’t believe ablation is safe for pregnant patients.

What to Expect:

  • The night before: no food or drink after midnight.
  • Your doctors will wear sterile masks and gowns.
  • A dim room helps doctors clearly see monitors.
  • The procedure takes 3 to 4 hours.
  • You’ll stay in bed for at least 4 hours more.

Preparing for an Ablation

This minimally invasive procedure uses high-frequency radio waves to selectively eliminate the heart cells that cause the arrhythmia. It can make your arrhythmia less severe and may even cure it. When you come in for the procedure, you’ll meet with the electrophysiology staff, who will explain the procedure to you and ask you to sign a form acknowledging that you understand the benefits and the risks of the procedure.

There are always risks to any invasive procedure. In this case, the most common risks include infection or bleeding. Other risks will be explained to you in detail. For example, ablation of certain areas of the heart may cause the heart to slow too much, requiring insertion of a permanent pacemaker. The risk of needing a permanent pacemaker is in the range of 1% or less for ablation of some arrhythmias, but virtually 0% for ablation of others.

You should let the staff know if you’re allergic to any medications or x-ray contrast dye, as well as the medications you are currently taking. You’ll be scheduled for some routine blood tests.

On the night before your ablation procedure, don’t eat or drink after midnight. You can take your medications on the morning of the procedure with a sip of water, unless the physician or nurse has instructed you otherwise.

When you arrive at the Electrophysiology (EP) Lab, you’ll be asked to change into a hospital gown and then will be assisted onto a padded x-ray table. Your heart rate and blood pressure will be checked and you’ll be placed on a heart monitor. An intravenous (IV) line will be started. You’ll be given a mild sedative through the IV to help you relax and make you sleepy throughout the procedure.

During Ablation

A team of specialists, including electrophysiologists, one or more nurses, an EP technologist and a radiology technologist, will perform your ablation. The members of the team will check you throughout the procedure to monitor your condition. Feel free to ask them any questions you may have during the procedure.

The procedure site (the groin area) will be shaved and washed with an antiseptic soap. You’ll then be covered from your neck to your toes with a large sterile sheet that helps to prevent infection. The electrophysiologists will wear masks, gowns and gloves in order to maintain sterile conditions during the procedure. And the lighting in the EP Lab will be dimmed during most of the procedure to allow the physicians to view the heart monitors and x-ray screens more clearly.

A local anesthetic similar to the type you receive at the dentist will be administered at the sites chosen for insertion of the catheters. You may feel a sting or slight pressure as the area is anesthetized, and some pressure as the catheters are inserted. If you experience undue discomfort, please let the physicians or nurse know so they can provide you with additional pain relief. Once the catheters are in position, you should feel comfortable.

Before the actual ablation can be performed, the physicians must first identify the area where your abnormal rhythm is coming from. They’ll record the electrical activity of your heart during your abnormal rhythm to create a “map” of the precise area of heart muscle responsible. During this time you may experience some palpitations, but otherwise you’ll be resting quietly. Once the physicians have identified the mechanism of your abnormal rhythm, they’ll insert the catheter that will deliver the radiofrequency energy. They’ll position the catheter tip against the inner surface of the heart muscle as close as possible to the site of origin of your abnormal rhythm. A surgical robot may be used to position the catheter more precisely.

Radiofrequency current will then be passed into the area through the tip of the catheter to cauterize the cells responsible for the abnormal heartbeat. If you experience any chest discomfort or pressure, be sure to inform the staff during the procedure. The length of the procedure is variable, but it usually lasts from three to four hours.

Following Ablation

When the procedure is finished, you’ll be moved to a gurney and taken to a recovery area. Under the physician’s guidance, a technician will remove the catheters and apply pressure to the sites for approximately 20 minutes to control any bleeding that may occur. Once you’re stable, you’ll be transferred to a regular hospital room. The nurse will check your blood pressure and heart rate, and monitor the insertion sites and pulses at regular intervals. You’ll be able to resume your previous diet shortly after the procedure is completed and you’re considered stable.

You’ll need to stay in bed for at least four hours following the procedure. The leg into which a catheter was inserted must remain straight and at rest so that the wound can heal properly.

One of the physicians who performed your procedure will visit you later in the day to examine the insertion sites. The physicians may discharge you the afternoon or evening of the procedure if your recovery is normal. You must have someone available to drive you home and stay with you that evening. Otherwise, you will be monitored overnight and discharged the following morning. Recovery from catheter ablation is quick. After 24 hours, you should feel free to resume most of your usual activities.

Date Last Modified: January 21, 2011

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