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Radiofrequency and Cryo-ablation

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 identified, an ablation catheter is placed near the problem tissue. Energy sent through this catheter ablates (destroys) the targeted tissue and eliminates 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.

Radiofrequency ablation (RFA) is an option for patients who:

  • Have arrhythmias that cannot be controlled with medication or lifestyle changes;
  • Do not wish to or cannot take anti-arrhythmia medications for a long period; 
  • Have atrial fibrillation and are at high-risk for stroke; or 
  • Have ventricular arrhythmias that put them at risk for sudden cardiac death.

Days before a procedure

  • Give your provider a complete list of all your medications and supplements. Include the name, strength and number of times you take it each day. Ask if, and when, you should stop taking any of these medications before the procedure.
  • Notify your provider of any bleeding problems you may have, or if you are taking warfarin (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.
  • Notify your provider of any allergies; foods, medicine or iodine.
  • Patients with a history of kidney problems may require special preparation.
  • A few days before your scheduled procedure, your provider may order standard tests, such as an electrocardiogram, chest x-ray, or routine blood tests.
  • Ask a family member or friend to drive you home.

Evening before and morning of the procedure

  • Eat a normal meal the evening before your procedure. DO NOT eat, drink or chew anything after 12 midnight.
  • Take any needed medicines with a small sip of water.
  • Bring a list of all current medications with you to the hospital; including the dosage and number of times you take the medication daily.
  • Leave valuables at home or with a family member.
  • Bring a photo ID and insurance cards to the hospital registration desk.

After check-in

  • You will be taken to the pre-procedure area.
  • You will change into a hospital gown.
  • Nurses will complete important paperwork.
  • You will be attached to a heart and BP monitor.
  • An intravenous (IV) catheter will be placed in a vein in your arm.
  • Family can be with you in the pre-procedure area.

During the procedure

  • You will receive sedatives, medications, and fluids through the IV during the procedure.
  • The access site (usually the groin) is scrubbed with an antiseptic scrub, the area is shaved.
  • After you become drowsy from the sedative, your doctor inserts 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; your doctor monitors the catheter’s progress with x-ray.
  • The doctor sends electrical impulses to your heart to identify and locate the source 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. Radiofrequency 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, wiggle your toes, or a nurse can help you roll to you side.
  • 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 provider 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.
  • Do not lift over 10 pounds for a week and wait 24-48 hours to get the puncture site wet. You may remove the dressing when you shower or bathe.
  • You may feel fatigue or chest discomfort during the first 48 hours after the procedure. Please tell your provider 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.
  • Depending on the type of ablation you may be discharged the same day or next day.
  • Do not drive until given the OK by your provider.

Call the office and speak to a nurse if you are having:

  • Increased pain in the access site.
  • Redness, swelling or drainage from the access site.
  • Fever of 100.5 or higher.

 

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