Catheter ablation is a procedure that is used to destroy (ablate) areas of the heart which are causing arrhythmias.
In a radiofrequency ablation, electrophysiologists pinpoint the area and then use radio wave energy to “cauterize” the tiny part of the heart muscle causing the abnormal heart rhythm. Catheter ablation plays an important role in the management of most types of cardiac arrhythmias.
How is this procedure done?
The procedure is done in the EP lab under the direction of a team of highly trained doctors, nurses, and technologists.
Ablation Catheter Accessory Pathway
During the procedure, you will lie on a padded X-ray table. You will have a blood pressure cuff on your arm, a clip on your finger to monitor oxygen, and wires on your legs, arms, and chest to check your heart rate. The nurse will give you pain medication and a sedative. The amount of sedation is adjusted for patient comfort.
The area of your chest and groin where the doctor will be working will be cleaned and shaved and you will be covered with sterile drapes from your shoulders to your feet. The doctor will give you a small needle to numb the area where the catheters will be inserted.
Using X-rays as a guide, the doctor will pass several small catheters through veins in the groin or neck and position them in the area that is interfering with the heart’s normal electrical activity.
A diagnostic EP study (described above) is always performed as part of the catheter ablation procedure to accurately diagnose the heart rhythm abnormality. Three dimensional mapping, using a previously acquired MRI or CT scan, may sometimes be required as determined by your physician.
If one of the many arrhythmias that are curable with ablation is identified, a catheter is guided to the site of the abnormal heart rhythm. Thermal energy (extreme heat) or cryoenergy (extreme cold) is then passed through the catheter to this site to destroy the problem-causing tissue.
This procedure typically lasts three to five hours.
What else do I need to know?
You should avoid eating or drinking anything after midnight the night before the study except for your normal medications, unless otherwise directed by your doctor or nurse. Once at the EP lab, a nurse will place an IV in your hand or arm so that you can receive fluids and medications.