Catheter ablation

Overview

Catheter ablation is a minimally invasive procedure used to treat rapid heartbeats, also known as arrhythmias. During this procedure, a small tube called a catheter is inserted into your heart through a blood vessel. This technique is employed by cardiologists, who are experts in managing heart conditions, to intentionally eliminate abnormal heart tissue in order to restore proper heart function.

Catheter ablation aims to generate tissue scarring in the specific region of the heart where the arrhythmia is present. This procedure utilizes either heat or cold energy to induce scarring within the affected heart tissue. These scars serve to block irregular electrical signals and prevent abnormal heart rhythms. Importantly, only the tissue responsible for the abnormal heart patterns is targeted and destroyed. This procedure does not result in any lasting effects or interfere with the normal functioning of your heart.

Types of catheter ablation

• Radiofrequency ablation: Heart tissue receives thermal energy via radiofrequency.
• Cryoablation: By using cold energy, heart tissue is frozen and scarred during cryoablation.

Reasons for undergoing the procedure

Catheter ablation is considered as a treatment option for various types of rapid cardiac arrhythmias when medications prove ineffective in restoring normal heart rhythms. The following arrhythmia types can be addressed through catheter ablation:

• Atrial Fibrillation (AFib) and Atrial Flutter. The atria, or top chambers of the heart, beat inefficiently and irregularly when you have atrial fibrillation or AFib. The atria do not contract; instead, they quiver. The heart cannot adequately pump blood through it properly because of this lack of contraction. Because AFib causes the blood in your left atrium to stay stagnant, it can lead to clots that raise your risk of stroke.
• Supraventricular Tachycardia (SVT). Episodes of rapid, irregular heartbeats, reaching up to 300 beats per minute, are common in people with SVT. Although your heart can still pump blood normally, frequent or prolonged episodes of SVT might harm it.
• Ventricular Tachycardia (VT). The ventricles, the lower chambers of the heart, have the capacity to beat rapidly and independently, posing a potentially severe arrhythmia that often results in cardiac arrest.

In addition, medical professionals might advise catheter ablation if you have a high risk of:

• Ventricular fibrillation (V-Fib): an irregular and ineffective heartbeat that comes from the ventricles, the lower heart chambers.
• Sudden cardiac arrest: when an unexpected stop to your heart occurs.

Risks

Catheter ablation carries few dangers. After catheter ablation, complications are not common. Potential dangers consist of:

• Blood clots.
• Stroke.
• Infection or bleeding.
• The requirement for a long-term pacemaker.
• Vein damage resulting from the catheter or sheath.
• Injury to the heart valves or cardiac tissue.

During radiofrequency catheter ablation, you do get some radiation. Ask your doctor if it is okay for you to postpone the surgery until after your baby is delivered if you are pregnant.

Before the procedure

In order to determine the most appropriate treatment plan for your specific arrhythmia, your healthcare provider will conduct a comprehensive evaluation of both your heart condition and overall health.

Before the surgery, your healthcare provider will provide you with specific and detailed instructions. You may be required to:

• Quit using drugs that thin the blood, such as warfarin or aspirin. Pay attention to your doctor’s instructions and cease taking these drugs only when instructed.
• Steer clear of food and liquids for a few hours before to your surgery. You will receive precise instructions from your provider.
• Dress comfortably, and leave valuables and jewelry at home.
• Make plans for a ride home following the operation or pick-up.

During the procedure

In a hospital, catheter ablation is done by a cardiologist. Following the procedure, you will need to stay at the hospital for six to eight hours. You might stay the night in the hospital or return home that day, depending on your condition.

An Intravenous (IV) line will be inserted into your arm by a nurse to help you get ready for the surgery. Anesthesia is among the medications that can be administered via the IV line. Even though you might be awake during the process, you will at least be given sedation, much like you would during a colonoscopy. The kind of surgery you’re having may need you to be put under general anesthesia. Your doctor will talk to you about this and set up a suitable time.

Your doctor will:

• Creates an opening by inserting a tiny tube, known as a sheath, through the skin and into a vein. Typically, medical professionals use an artery or vein in your groin. Occasionally, they pass through the veins in your neck or arm.
• Next, they slide the electrode catheters—which are essentially tiny tubes with wires—into the sheath. Using X-rays as guidance, they thread the catheters through your vein or artery and up to your heart.
• Applies heat or cold energy via the catheter to the parts of your heart that are generating irregular heartbeats. In order to stop those irregular cardiac rhythms, the catheter destroys the aberrant heart tissue.
• Extracts the sheath and catheter from your artery or vein.

Typically, the catheter is inserted by your doctor into a sizable artery or vein in your groin. Occasionally, doctors decide to use a vein in your neck or arm instead. The ideal site will be determined by your healthcare expert based on your anatomy and health.

After the procedure

The catheter ablation procedure typically takes approximately two to four hours to complete. After the surgery, you will spend several hours in a recovery room, where a nurse will closely monitor your condition as you recover.

Upon discharge, you will receive comprehensive instructions for at-home care. Your doctor may prescribe aspirin or another blood-thinning medication to help prevent blood clots, and the duration of this medication regimen will depend on your individual medical history. You may need to continue taking these medications for several months or possibly even longer after the treatment.

Outcome

The complete healing process can span several weeks, during which arrhythmias may persist while the heart tissue recovers.

Typically, you should be able to return to work within five to seven days after your treatment, unless your job involves heavy lifting or other physically demanding activities.

For at least one week, it’s advisable to avoid strenuous lifting and vigorous exercise. To determine when it’s safe to resume your physical activities, consult with your physician.