Catheter Ablation

An arrhythmia is a problem with the rate or rhythm of your heartbeat. If you have an arrhythmia, your healthcare provider may recommend a procedure called catheter ablation. It can improve or even cure your condition.

What is catheter ablation?

This procedure guides a wire into your heart to destroy small areas of heart tissue that may be causing your abnormal heartbeat. Heat (radiofrequency) or cold energy (cryoablation) are the 2 most common ways to destroy abnormal heart tissue. It is an alternative to long- term or lifelong medication therapy. It is also an option when medicine fails to control the heart rhythm problem.

What happens during the procedure?

Catheter ablation can take anywhere from 3 to 6 hours. It usually done in an electrophysiology lab by a cardiac electrophysiologist. This is a cardiologist with special training in the management of abnormal heart rhythms.

Before the procedure starts, you will be given intravenous (IV) medicine to help you relax. Some people even fall asleep. In some cases, you may be put to sleep with anesthesia.

After the medicine has taken effect, your doctor will numb an area in your groin. Rarely the arm or neck is used. Next, your doctor will insert several IV lines (IVs) into a blood vessel and advance them to the heart. Through these IVs, your doctor can insert several wires and a small catheter into the heart. A type of X-ray helps the doctor view the heart and wires as the procedure is happening.

After the catheters are positioned, your doctor sends heat or cold energy from the tip of the catheter to destroy (ablate) the problem area of cells. After ablation, your doctor will test your heart to make sure that the abnormal heart rhythm is no longer present.  Medicine to stimulate the heart may also be used to test for abnormal heart rhythms.

Most people do not feel pain during the procedure. You may sense mild discomfort in your chest or shoulder area. After the ablation, your doctor will remove the guide wire and catheter from your chest.  Pressure is applied to the insertion site to stop any bleeding.

What happens after the procedure?

After the catheter ablation, you will be told to lie still for 4 to 6 hours to decrease the risk of bleeding. Your heart rhythm will be monitored. You will be offered pain medicine if needed. Depending on how your heart is doing and what type of ablation procedure was done, you may be able to go home the same day. In other cases, you may need to stay overnight.

Managing after a catheter ablation

In the days after the procedure, you may have mild symptoms such as an achy chest and discomfort or bruising in the area where the catheter was inserted. You might also notice skipped heartbeats or irregular heart rhythms.

Avoid driving for the following day. Don't lift anything over 10 pounds for the next few days. Avoid exercise for the next 5 days, or until you see your doctor for follow up.

Depending on the type of arrhythmia being treated, catheter ablation can have a success rate of more than 90%. Some people may need to have the procedure again or other treatments for heart arrhythmias. Your doctor may want you to stay on medicine to help control your heartbeat. 

After your catheter ablation, follow all instructions from your doctor. This is especially important for follow-up visits, medicine schedules, and safe levels of physical activity.

When should I call my healthcare provider?

Contact your doctor right away if you have:

• Unusual pain or swelling

• A fever of 100.4°F (38°C) or higher

• Excessive bleeding

• Consistent irregularities in your heartbeat