An ablation procedure is a non-surgical technique that ablates or destroys abnormal tissue areas in the heart that is the source of abnormal rhythms. Ablation procedures are often performed in conjunction with an EP study.
During the procedure, once the exact area to be ablated is found, an ablation catheter is placed near the problem tissue. Energy sent through this catheter “ablates” the abnormal tissue of the heart muscle and destroy the pathway of the abnormal rhythm.
The type of ablation performed depends upon the type of arrhythmia. For the vast majority of arrhythmias a single ablation procedure is usually enough to treat a heart rhythm problem.
RFA is an option for patients who:
- have arrhythmias that cannot be controlled with medication or lifestyle changes;
- do not wish to take anti-arrhythmia medications for a long period;
- have atrial fibrillation and are at high-risk for stroke; and
- have ventricular arrhythmias that put them at risk for sudden cardiac death.
Before the procedure
- Please ask your doctor whether you should stop your heart rhythm medication several days before the procedure.
- The morning of the procedure take routine medications with small sips of water.
- Bring all current medications with you including the dosage and number of times you take the medication during a 24-hour period.
- Notify your doctor of any bleeding problems you may have, or if you are taking coumadin or other blood thinning medication. If you are a diabetic, a change may be required in your insulin or pill regimen on the morning of the procedure.
- Eat a normal meal the evening before your procedure. DO NOT eat, drink or chew anything after 12 midnight.
- Remove all makeup and nail polish.
- Wear comfortable clothes. A hospital gown will be provided.
- Leave all metal objects such as keys, jewelery, and watches at home.
During the procedure
- An IV (intravenous line) inserted in your arm administers sedatives, medications, and fluids during the procedure.
- Your neck, upper chest, arm or groin are cleansed with an antiseptic solution, and the catheter insertion site(s) is shaved.
- After you become drowsy, your doctor inserts several catheters through a small incision into a large blood vessel.
- The catheters are advanced through the blood vessels to your heart. You will not be able to feel the catheter, but your doctor monitors the catheter’s progress.
- The doctor sends electrical impulses to your heart to increase your heart rate and uses the catheters to locate the origin of the arrhythmia.
- When the exact area to be ablated is found, the ablation is done by inserting a special electrode catheter near the problem pathway or circuit. Energy waves are sent through the catheter to destroy (ablate) the problem tissue.
- Once the ablation is complete, the electrophysiologist monitors the electrical signals in your heart to ensure that the abnormal rhythm was corrected.
- A catheter ablation procedure may last between 2 to 4 hours.
After the procedure
- After your ablation procedure is completed and the catheters are removed, a nurse applies firm pressure over your groin area for 10 to 20 minutes to prevent bleeding.
- In the recovery area, you will be asked to lie flat in bed from 3 to 6 hours to allow a seal to form over the puncture in the blood vessel. Do not bend or lift the leg where the catheters were inserted. To relieve stiffness, you may move your foot or wiggle your toes.
- Your nurse checks your heart rate and rhythm, pulse, blood pressure, and catheter puncture site(s). If you feel sudden pain at the site or if you notice bleeding, notify the nurse immediately.
- Your doctor discusses the results of the procedure and answers your questions. You will receive specific instructions about how to care for yourself after the procedure including medication guidelines, wound care, activity guidelines, and a follow-up schedule.
- No stitches are needed. A small sterile dressing covers the insertion site. Keep this area clean and dry. Notify your doctor or nurse right away if you have redness, swelling, or drainage at the procedure site.
- 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 abnormal heartbeats after the procedure. After your heart has healed, these experiences should subside.