Thin, flexible wires called catheters are inserted into a vein, typically in the groin or neck. They are threaded up through the vein and into the heart. There is an electrode at the tip of each wire. The electrode sends out radio waves that create heat. This heat destroys the heart tissue that causes the fast heart rate. Another option is to use freezing cold to destroy the heart tissue.
Catheter ablation is done in a hospital where the person can be carefully monitored. The procedure is done with an electrophysiology (EP) study, which can identify specific areas of heart tissue where the fast heart rate may start or where abnormal electrical pathways are located inside or outside the atrioventricular (AV) node. This allows doctors to pinpoint exactly what tiny area of heart muscle to destroy.
A local anesthetic is used at the site where the catheter is inserted. The person usually stays awake during the procedure but may be sedated.
What To Expect After Treatment
Recovery from catheter ablation is usually quick. Some people may be hospitalized for 1 to 2 days after the procedure so doctors can monitor heart rate and rhythm. Many people go home the same day.
Why It Is Done
Catheter ablation is often used for people who have persistent or recurrent fast heart rates that do not respond to drug therapy. Or it is used for people who have certain types of fast heart rates and who do not want to take medicine.1, 2
Ablation might be done to treat:
How Well It Works
This procedure can successfully eliminate WPW most of the time. There is a small risk of the arrhythmia recurring even after successful ablation of WPW. But a second session of catheter ablation is usually successful.2
For ventricular tachycardia, catheter ablation might make the arrhythmia happen less often or stop the arrhythmia from happening again.1
Catheter ablation is considered safe.
It has some serious risks, but they are rare. They include:
- Heart attack.
- Puncture of the heart.
- Need for emergency heart surgery.
- Problems with the pulmonary vein.
- A leaking blood vessel.
- Nerve damage that causes paralysis of the diaphragm.
- Cardiac tamponade.
- Atrio-esophageal fistula. In this life-threatening condition, a hole forms between the heart's upper chamber and the esophagus.
- New heart rhythm problems.
- Death (very rare).
You will have to decide whether the possible benefits of ablation outweigh these risks. Your doctor can help you decide.
In catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT), damage to the heart's conduction system requires a permanent pacemaker in about 1 out of 100 people.2 With other types of supraventricular tachycardia, where the abnormal cells are not close to the heart's normal conduction system, there is almost no risk of needing a pacemaker.
What To Think About
For help on the decision to have catheter ablation, see:
Aliot EM, et al. (2009). EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias. Heart Rhythm, 6(6): 886-933.
Blomström-Lunqvist C, et al. (2003). ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias-Executive summary: A report of the ACC/AHA/ESC Committee for Practice Guidelines. Circulation, 108(15): 1871-1909.
Primary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical ReviewerJohn M. Miller, MD, FACC - Cardiology, Electrophysiology
Current as ofFebruary 20, 2015