Are you confused about cardiac ablation for heart arrhythmias?

Medically, ablation is considered to be a ‘removal or excision,’ usually in referencing the removal of material from the surface of an object to improve its function.

Typically, cardiac ablation is a way to intentionally damage or modify cardiac tissue that is responsible for heart rhythm problems (cardiac arrhythmias), primarily rapid heartbeats (tachycardia) or irregular rhythms from frequent premature beats or even atrial fibrillation.

This article will go through the details of cardiac ablations, so keep reading to learn the benefits of this highly sophisticated procedure.

What Is a Cardiac Ablation?

Abnormal heart rhythms frequently cause uncomfortable symptoms such as palpitations, breathing problems, dizziness and even fainting.  Medical therapy can be used but is not always effective to control the symptoms. Some arrhythmias can even be dangerous to live with. A cardiac ablation is a medical procedure used to correct these heart rhythm problems and relieve the symptoms. Ablation procedures can improve a patient’s quality of life and may help to prevent long-term heart damage from occurring.

The ablation process involves destroying the specific heart tissue that is responsible for triggering the abnormal heart rhythm. Sometimes, arrhythmias arise from one small area of the heart (a “focus”) and can be destroyed easily by applying energy to damage that one little spot. Other arrhythmias are due to an electrical short circuit caused by the presence of an abnormal pathway within the heart. In that case the abnormal pathway can be interrupted with a series of burns to create an intentional scar that blocks the circuit.  When completed successfully, a cardiac ablation will prevent unwanted electrical signals from arising from the heart, which will permanently stop the abnormal heartbeats.

Atrial fibrillation is an arrhythmia that can often be treated with ablation. In that arrhythmia, the abnormal electrical signals do not come from one specific spot or circuit in the heart but can arise from any number of places. Most commonly, the veins behind the left atrium (called pulmonary veins, since they bring blood from the lungs back to the heart) are the first targets of ablation since most atrial fibrillation arises there. That ablation procedure involves creating circular scars that wall off those pulmonary veins to block the abnormal electrical activity from reaching the rest of the heart. Unfortunately, atrial fibrillation can sometimes recur even after a successful ablation, so the procedure may need to be performed more than once.

Ablation may not be the first treatment option that your doctor will recommend, depending on the specific heart arrhythmia you are suffering from. However, it may be more appropriate for people who fit the following qualifications:

  • Little or no success with conventional medications for arrhythmia
  • Patients who experienced side effects from medication used to treat arrhythmias
  • High risk for complications caused by arrhythmias, like cardiac arrest
  • Have a specific type of arrhythmia (PSVT, typical atrial flutter, or Wolff-Parkinson-White syndrome) that responds well to ablation

What Is the Cardiac Ablation Process Like?

In the past, cardiac ablations were done by a surgeon during open heart surgery. Nowadays, nearly all ablations are performed by heart rhythm specialists known as cardiac electrophysiologists.

Catheter ablation procedures typically take place in the hospital. Before the process begins, patients generally are given a sedative or even general anesthesia to put them in a sleep-like state that makes inserting the catheters and performing the procedure totally painless. Once the sedative becomes effective, the electrophysiologist will numb the skin over the vein at the top of the leg using a local anesthetic.  They will then insert special wires called EP catheters into the vein to test the electrical system of the heart (known as electrophysiologic testing) and locate the source of the arrhythmia (known as catheter mapping). Once the abnormal tissue is identified, the doctor will place the catheter directly at the area to be damaged, and electrical energy or (less commonly) freezing cold temperatures are used to create the scar or destroy the tissue that is causing the arrhythmia. The procedure is invasive, but it is not considered surgery, so the complication rate is very low and recovery time after the procedure is quite short. Rarely, a catheter will have to be inserted into an artery or into a vein in the neck to reach the source of the arrhythmia.

In some cases, the ablation procedure is utilized to block the electrical signals traveling through your heart, to contain the abnormal heartbeats and help reduce the symptoms.

Typically, cardiac ablation takes between two and four hours to complete, though complicated procedures can take significantly longer and simple cases can actually take less time. Generally patients do not feel pain during the process, and they usually won’t remember most of the procedure.

Recovering After a Cardiac Ablation

After undergoing an ablation procedure, you will be moved to a recovery room to rest for several hours. This is to prevent you from bleeding from the catheter site and to monitor your heartbeat and blood pressure and ensure that there were no complications.

Depending on your overall health and the type of ablation procedure, you may go home after several hours, or more commonly after an overnight stay. It’s normal to feel a little sore for a couple of days afterwards, but this discomfort should resolve quickly. It’s expected that you will return to your regular activities a few days after the procedure.

Undergoing a cardiac ablation procedure might seem frightening at first, but it is actually a relatively safe procedure with little or no discomfort, and is highly effective for most arrhythmias. If other methods haven’t worked to treat your arrhythmia, looking into an ablation might be the right solution for your health.

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