Cardiac (catheter) ablation

What is cardiac ablation?

Cardiac, or catheter ablation is a treatment which is used to treat heart rhythm problems such as atrial fibrillation. Cardiac ablation destroys diseased areas of the heart and can prevent abnormal electrical signals from moving through it.

Why is cardiac ablation performed?

Cardiac ablation is performed in order to correct heart rhythm problems (arrhythmias). It is not usually used as a first line of treatment but can be used after medication has been unsuccessful in treating the arrhythmia. It can also be used in those who suffer serious side effects from arrhythmia medications. In certain cases, there are arrhythmias which respond well to cardiac ablation, including types such as Wolff-Parkinson-White syndrome.

What happens during cardiac ablation?

Cardiac ablation is a minimally-invasive procedure. A small incision is made in the forearm, groin, or neck, where a catheter (small flexible probe) is inserted and guided through to the heart. Dye may be injected into the catheter, which can help the specialist see your blood vessels and heart through X-ray images.

Once the catheter is placed, small electrodes connected to monitors are placed on different areas of the heart to detect which areas are causing the arrhythmia. Once the source of the problem is detected, one of the catheter's pathways is used to send electrical energy, causing a small scar and stopping the heart rhythm problem.

The procedure can take between three and six hours. During the process, the heart is monitored very closely, and some discomfort is normal, but you should let the doctor know if you feel any pain or shortness of breath.

Preparing for cardiac ablation

Before the procedure, your doctor may perform tests to check you are suitable for the procedure. The night before the procedure is done, you will need to make sure to stop eating and drinking, and not eat or drink in the morning beforehand. Speak to your doctor about any medication you are taking as they may advise you not to take it in the days running up to the procedure.

Before cardiac ablation is decided upon as a course of treatment, your cardiologist will speak to you to evaluate which path is best, as ablation carries certain risks which must be taken into account. Risks include:

  • Damage to heart valves
  • Damage to the heart’s electrical system
  • Blood clots
  • Stroke
  • Heart attack
  • Kidney damage (from dye used in the procedure)
  • Bleeding or infection at the puncture site
  • Pulmonary vein stenosis
  • Death (in rare cases)

This said, cardiac ablation is considered to be a low-risk procedure. 

Post-operative care

After the cardiac ablation, you will need to rest in the clinic or in the hospital for several hours, so bleeding is prevented at the site where the catheter was introduced, and your heart beat can be monitored. During the two or three days after the procedure you may experience chest pain, fatigue, or fast or irregular heartbeat, which can be relieved by medications prescribed by the healthcare provider. You may also need to make some lifestyle changes as advised by your doctor in order to improve the overall health of your heart, as poor heart health can worsen arrhythmias.