Ablation: What You Should Know
What Is an Ablation?
This procedure uses heat or cold to create scars on a specific piece of your heart tissue. The scarring helps block the electrical signals that cause irregular heart rhythms in conditions such as atrial fibrillation (AFib). A doctor may perform the ablation with a small thin tube (catheter) inserted into a vein or artery or with surgery.
Who Is Ablation For?
If medication for your irregular heartbeat, also called arrhythmia, didn’t work or caused serious side effects, your doctor may recommend ablation. Ablation works especially well in certain types of arrhythmia, such as Wolff-Parkinson-White syndrome, supraventricular tachycardia, and AFib.
Types of Ablation: Catheter
Doctors most commonly use the less invasive catheter procedure to perform an ablation. They typically guide the catheter through a vein in your groin and up toward your heart. The catheter then scars the heart tissue with hot or cold energy.
Types of Ablation: Surgical
Surgical ablation is less common, but your doctor may do it if you’re already having another heart procedure, such as a bypass or valve replacement. This open-heart surgery is called a maze procedure and uses the same cold and hot energy to scar the heart tissue that catheter ablation does.
During the Procedure: Catheter
Your doctor will put you under general anesthesia for a catheter ablation, which takes about 2 to 4 hours. They’ll numb your groin area, make a small hole, and insert the catheter into a vein. Using electrodes, they will trigger your heart to help see where the problem area is before using heat or cold to destroy the tissue.
Recovery: Catheter
After the procedure, you’ll lie still for a few hours to reduce the risk of bleeding. Many people go home the day of the procedure, but others may spend a night or two in the hospital. It’s normal for your chest to feel achy and uncomfortable. You may have some bruising, too. You should be back to normal within a few days.
During the Procedure: Surgical
After your doctor gives you general anesthesia, they’ll cut down the middle of your chest and separate your breastbone to reach your heart. They’ll connect you to a machine that keeps your heart and lungs working during the surgery. After the procedure, you’ll come off the machine and the doctor will wire your breastbone back together and close the cut with stitches or staples.
Recovery: Surgical
You’ll likely start in the intensive care unit (ICU). You may stay there for a few hours or up to a few days. You’ll be in the hospital for several days after that. Your doctor may have you take a blood thinner to help prevent clots from forming. It may be several weeks before you can return to normal activity.
Risks and Complications
An ablation can cause blood clots, vein and heart damage, narrowed veins between the heart and lungs, bleeding, an infection, a heart attack or stroke, and in rare cases death.
How Successful Is It?
Ablation has an 80% to 90% success rate, depending on how advanced the arrhythmia is. After you have it, your doctor may want you to continue taking medication for your irregular heart rhythm. It’s also possible for your arrhythmia to come back. If this happens, your doctor may choose to do another ablation.
Sources Medically Reviewed on 05/16/2023 Reviewed by James Beckerman, MD, FACC on May 16, 2023
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SOURCES:
Cleveland Clinic: “Heart Ablation.”
Mayo Clinic: “Cardiac Ablation.”
Johns Hopkins: “Catheter Ablation,” “AFib Surgery and Maze Procedure.”
University Hospitals: “Rewiring the Heart: Catheter Ablation for AFib.”
Reviewed by James Beckerman, MD, FACC on May 16, 2023
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