What is a cardiac ablation?

Cardiac ablation is a procedure that allows to solve problems in the heart rhythm (tachycardias or arrhythmias), by means of an intervention using a catheter.

Cardiac arrhythmias occur when there is an alteration in the normal electrical activation of the heart, creating a disorder in the natural heart rhythm. Cardiac ablation aims to restore the normal rhythm and, in some cases to permanently eliminate the arrhythmia, by healing the heart tissues where this abnormal rhythm is caused.

Cardiac ablation is carried out using flexible catheters that are inserted through a vein or an artery, usually from the groin, thus accessing the heart with the purpose of rectifying the tissues that cause arrhythmia, applying energy in the form of extreme heat or cold.

When is cardiac ablation necessary?

Cardiac ablation is a technique that tries to solve heart rhythm problems (arrhythmia), but it is not usually the first option of treatment. Thus, cardiac ablation will be performed on people who:

Have been treated with drugs to control arrhythmia and have not been successful.
Have experienced serious side effects related to pharmacotherapy.
Have been diagnosed with a type of arrhythmia, such as Wolff-Parkinson-White syndrome and supraventricular tachycardia, which responds very well to cardiac ablation therapy.
In cases of arrhythmias that pose a high risk to the patient, such as cardiac arrest.

How to prepare before a cardiac ablation?

Before the intervention, the medical team will explain to you everything about the test: what it consists of, what preparation you must follow and what are the risks or complications that exist with this procedure. Some of the issues to consider are:

Medication that you are taking before the intervention.
Advance instructions or medication that you should take before the procedure.
Inform if you wear any medical device such as pacemaker or defibrillator.

What does the intervention consist of?

Cardiac catheter ablation is an intervention that is normally performed with a 24-48h hospital stay. First, the medical team will place an IV line for the administration of a sedative or anesthesia to keep the patient relaxed and calm during the procedure.

The energy that is usually used for the cardiac ablation procedure is:

Extreme cold (cryoablation)
Heat (radio frequency)

The duration of the intervention tends to last between one and three hours, but this will depend on each case and its complexity.

Once the patient is sedated, doctors proceed to puncture the vein in the groin, neck, or forearm and, through this needle, a tube or sheath will be placed that will guide the catheters to the heart. The doctor can inject contrast to help to visualize blood vessels and heart through x-ray images.

The inserted catheters have electrodes at the tips that will send electrical impulses to the heart to detect the exact tissue from which the abnormal electrical activity is coming. The energy applied through the catheters (in the form of heat or cold) will heal the tissue that causes the arrhythmia.

After cardiac ablation

Once the procedure is finished, the patient must remain monitored in the observation area for a few hours to check that there is no bleeding in the areas where the catheters were inserted, or any other complication derived from the intervention.

It is possible that the patient goes home the same day of the surgical intervention, but that will strictly depend on the decision of the medical team.

Results

In the same way that a cardiac ablation intervention can have beneficial results for the patient, in some cases the arrhythmia does not disappear, and doctors can consider repeating the procedure.

Also, the patient may need to continue taking medication even after a successful intervention. In addition, he will need to adopt a series of measures that will help to maintain a healthy heart, that is, a healthy lifestyle to prevent the arrhythmia from getting worse.

Possible risks of having cardiac ablation

Like any procedure, cardiac ablation has a risk of complications, including:

Bleeding may occur where the catheter was inserted.
Damage to blood vessels can occur while the catheter travels to the heart.
Heart perforation
Damage to the heart valves
Heart’s electrical system may be damaged, which may require the use of a pacemaker to correct it.
Blood clots can appear in legs or lungs (venous thromboembolism).
Stroke or heart attack.
Narrowing of the veins that carry blood between lungs and heart (pulmonary venous stenosis).
Kidney damage due to the contrast used during the procedure.
It can be cause of death in exceptional cases.