SVT Ablation

Overview

Supraventricular tachycardia (SVT) ablation is a medical procedure designed to address irregular heartbeats caused by disruptive cells in the upper chambers of the heart. These cells generate abnormal electrical signals, leading to a rapid heartbeat. The ablation process involves introducing specialized catheters into the heart to locate and damage the problematic cells, creating controlled scars that prevent them from sending irregular signals. This intervention is considered when medication proves ineffective or causes undesirable side effects. Depending on the specific arrhythmia, concurrent health conditions, and the severity of symptoms, ablation may be chosen as the primary treatment or considered after other options.

The heart’s normal electrical system relies on a network of living fibers that transmit electrical signals, ensuring a regular heartbeat. However, in some individuals, these fibers can form a small loop, creating a short circuit that disrupts the heart’s natural rhythm. Ablation targets this loop by using catheters to administer controlled damage, either through radiofrequency to create a small scar by heating the loop or through cold nitric oxide to freeze the loop and generate a small scar. By interrupting the loop, the procedure restores the heart’s rhythm and addresses the underlying cause of the irregular heartbeat.

Reasons for undergoing the procedure

If you’re experiencing a rapid and irregular heartbeat due to conditions like atrial flutter, atrial tachycardia, AVNRT, AVRT, Wolff-Parkinson-White syndrome, orthodromic atrioventricular reciprocating tachycardia, or antidromic atrioventricular reciprocating tachycardia, your healthcare provider might recommend SVT ablation.

SVT ablation could be considered as an initial treatment or when other medications and therapies haven’t been effective. The decision to undergo SVT ablation is typically made collaboratively between you and your healthcare provider, weighing the potential benefits and risks.

For children with supraventricular tachycardia (SVT) at high risk of heart-related complications or those whose condition hasn’t improved with other treatments, SVT ablation may be a viable option. It’s essential to discuss this with your healthcare provider to make an informed decision.

Risk

Occasionally, bleeding or infection may occur following SVT ablation. Additional risks include:

• Cardiac tamponade.
• Formation of blood clots.
• Hematoma formation (accumulation of blood).
• Adverse reactions to anesthesia.
• In rare cases, the regular parts of your heart’s conduction system might be harmed, necessitating the use of a pacemaker.

Before the procedure

Before undergoing an SVT ablation, one will be required to abstain from eating and drinking for a period of six to eight hours. Taking specific medications may be discontinued in preparation for the procedure. This preparatory phase is crucial to enhance the effectiveness and safety of the SVT ablation.

During the procedure

In an electrophysiology laboratory, a healthcare provider will administer pain medication through an intravenous (IV) line in your arm. They will then puncture the skin in your groin area and introduce a catheter (tube) into a blood vessel. Following this, an electrode catheter will be inserted and advanced to your heart. Signals will be transmitted through the electrode catheter to identify abnormal cells. Once located, the problematic cells will be treated by applying ablation. The physician will select one of the following ablation techniques to create small scars in the heart and disrupt irregular heart rhythms:

• Extreme cold (cryoablation)
• Heat (radiofrequency energy)
• Lasers

After the procedure

The SVT ablation procedure usually lasts from three to six hours, requiring an overnight hospital stay. Following the procedure, patients are moved to a recovery area for close monitoring. To ensure proper healing, it’s advised to keep the leg extended for six to eight hours after the removal of the catheter. Once the blood vessel is cleared, pressure is applied to the insertion site. While manual pressure is occasionally used, a vascular closure device is commonly employed to prevent bleeding from the vein. After discharge, patients can typically resume regular activities the next day, but it is advisable to wait for three days before engaging in more physically demanding tasks.

Outcome

After getting SVT ablation, most people feel better, with a success rate of 90% to 95% for different types of SVT. But sometimes, the fast heartbeat may come back. If that happens, the procedure might need to be done again, or other treatments might be suggested. It’s important to be aware of possible problems, so if you notice any of these signs, get medical help right away:

• Bleeding that won’t stop
• Sudden swelling
• Bruising
• Numbness in your leg
• Trouble breathing
• Chest pain
• Irregular heartbeat
• Feeling dizzy
• Upset stomach
• Fever