Catheter ablation is a way to treat irregular heartbeats, or arrhythmias, like atrial fibrillation (AFib), atrial flutter, or supraventricular tachycardia (SVT). It destroys the tissue that’s causing your heartbeat to get off course. This creates scar tissue inside your heart. This scar tissue is a good thing. It will help your heartbeat stay in rhythm.
Your cardiologist (a doctor who specializes in treating hearts) won’t have to cut into your chest to do this procedure. The catheter is a long, flexible tube that they insert into a blood vessel and guide into your heart. The catheter sends energy to the specific part of your heart that’s causing the abnormal heart rhythm.
AFib usually starts in the two upper parts of the heart (called the atria). When this happens, the normal communication between the upper and lower chambers of the heart is disrupted.
How Should I Prepare for My Catheter Ablation?
Before your procedure, your doctor may ask you to get some tests. They will tell your doctor more about your heart and overall health. They may include:
The day before your ablation, you should not eat or drink anything after midnight. Food or drinks in your stomach may cause you to react badly to your anesthesia during the procedure. For example, you might vomit, and it could get into your lungs.
What to Expect: Catheter Ablation, Step by Step
- A nurse will weigh you, give you a physical exam, take your medical history, ask you about all the medications you take, and review your blood test results for levels of blood thinner drugs.
- Your anesthesiologist will also examine you, ask you about your medical history, and talk to you about your anesthesia for the ablation.
- You’ll get anesthesia to put you under during the ablation. It is not a painful procedure.
- You’ll lie on a surgical table for your ablation.
- A nurse will attach electrocardiogram (EKG) electrodes on patches onto your back and chest. Wires attached to the electrodes will send signals to computers to guide your doctor during your ablation.
- If your skin has hair, a nurse may shave a small area where the catheter tube goes in. It will usually go in through a blood vessel in your groin at the top of your legs, or sometimes in your neck.
- Once your doctor puts the catheter into your blood vessel, they’ll guide it into the inside of your heart. They'll use ultrasound to see where it's going.
- Your doctor will use the end of the catheter to zap the spots in your heart that cause trouble. Afterward, the electrical current in the heart should be fixed and blood should flow normally.
- Doctors can use these energy sources to create the scar tissue:
- Radiofrequency waves
- Cryothermy (This freezes tissue, a process called cryoablation.)
Radiofrequency ablation and cryoablation are the most commonly used types.
Radiofrequency Ablation vs. Cryoablation
Radiofrequency ablation has been used for decades. With this method, it takes only about a minute for your surgeon to create the damage that leads to scar tissue. But it's less useful in areas where you have low blood flow. And its effect may not be permanent.
Cryoablation is a newer method that delivers extremely cold temperatures to freeze the trouble spots in your heart. It's reversible, which lets your surgeon test an area to see whether it works. If not, they can rewarm it with no damage. This process takes a few minutes longer than radiofrequency ablation.
Your doctor will choose an ablation method depending on the area of your heart they need to target and how comfortable they are with each procedure.
What Happens After Catheter Ablation?
You may have to stay in the hospital overnight after your ablation so your doctor and nurses can keep an eye on you while you recover. You’ll rest in bed after the procedure. Some people leave the hospital the same day, while others go home the next morning.
Your doctor will tell you how well the procedure went and how good a job it should do to treat your AFib.
What’s Recovery Like?
After you go home:
- You may feel sore, tired, or have some discomfort in your chest for a few days.
- You may need to nap more than usual for a few days as you recover.
- It can take several weeks for the work done during your procedure to turn into scar tissue. You might not have a normal heartbeat until the scar tissue forms. Your heart arrhythmia could seem the same or worse until then.
- You may need to take blood thinners for several months after your ablation.
- You may get antacids or anti-inflammatory drugs, too.
- Sometimes the procedure has to be repeated to work. Your doctor will check your heart rhythm in the days and weeks after your procedure to see if that’s something you’ll need.
Don’t lift, push, or pull any objects heavier than 10 pounds for about a week after your ablation. That means not doing things like mowing the lawn.
- Avoid intense exercise for about 3 weeks after your procedure, too.
- Make sure your surgical wounds stay clean and dry until they heal.
- You can take a shower, but for the first 5 days, don’t use very hot water or soak in the bath. Gently pat dry near your wound.
- Don’t use lotions or creams there.
- If you notice any signs of infection of your wound sites, such as a fever, redness, heat, or swelling, call your doctor.
What Are the Risks?
Your doctor should explain your risks to you. But common risks include:
How Successful Is This Procedure?
If your AFib does return, your doctor may be able to treat it with medications. Or you could need a second procedure. If your problems continue, your doctor might implant a pacemaker to control your heart’s electrical signals.
How Much Does It Cost?
No two hospitals will charge exactly the same, because no two people or cases of AFib are the same. If your doctor suggests catheter ablation for your heart arrhythmia, check with your insurance company to verify your coverage before you set up the procedure.