What Is Catheter Ablation?
Catheter ablation is a common, minimally invasive procedure that is often performed to treat fast heart rhythms, or tachycardia. A-Fib is the most common type of fast heart rhythm.
During catheter ablation, a thin, flexible tube called a catheter is inserted into your vein through a small incision in your arm or leg. Your doctor will guide the catheter to the part of your heart that is causing the fast heartbeat.
The catheter uses heat or cold to scar or destroy heart tissue. The scars block abnormal electrical signals that cause your fast heartbeat. This restores your normal heart rhythm.
A specially trained doctor called an electrophysiologist performs catheter ablation in an electrophysiology lab. The procedure does not require opening your chest.
Types of Catheter Ablation
Different catheter ablation procedures are used to treat different types of abnormal heart rhythms. Catheter ablation procedures include:
- Atrial flutter ablation, which treats a fast heartbeat called atrial flutter in the upper chambers of the heart.
- AV node ablation, which destroys tissue between the upper and lower chambers of the heart to treat A-Fib.
- Pulmonary vein isolation (PVI), which destroys tissue where the pulmonary veins connect to the heart to treat A-Fib.
- Supraventricular tachycardia (SVT) ablation, which destroys tissue in the upper chambers of the heart to restore a normal rhythm.
- Ventricular tachycardia ablation, which destroys tissue in the lower chambers of the heart called the ventricles.
What are the two forms of catheter ablation?
There are two ways that catheter ablation procedures are performed: Using radiofrequency electrical energy or super-cooled nitrous oxide. Radiofrequency electrical energy uses heat to destroy tissue, and super-cooled nitrous oxide uses cold.
Conditions we treat with catheter ablation
- Atrial fibrillation (A-Fib)
- Atrial flutter
- Atrial tachycardia
- Atrioventricular nodal reentrant tachycardia (AVNRT)
- Atrioventricular reentrant tachycardia (AVRT)
- Ventricular tachycardia
Why Would I Need Catheter Ablation?
Your doctor may suggest catheter ablation if your abnormal heart rhythm isn’t responding to medication. Catheter ablation is a minimally invasive treatment option that can reset your normal heart rhythm without the need for open-heart surgery.
Who’s a candidate for catheter ablation?
You may be a candidate for catheter ablation if:
- You have A-fib or another type of abnormal heart rhythm.
- Medications for your abnormal heart rhythm aren’t working.
- You have side effects from your abnormal heart rhythm medication.
- Your abnormal heart rhythm puts you at high risk of cardiac arrest or other heart complications.
Alternatives to catheter ablation
What Are the Risks and Complications of Catheter Ablation?
Catheter ablation is a safe and effective procedure when it is performed by an experienced electrophysiologist. However, there are risks associated with any medical procedure. Risks of catheter ablation include:
- Bleeding or infection at your incision site.
- Damage to your blood vessels or heart valves.
- Developing a new abnormal heart rhythm.
- Having your heart rhythm get worse.
- Stroke, blood clots or heart attack.
- Needing an implanted device such as a pacemaker to control heart rhythm.
How serious is heart ablation surgery?
Heart ablation surgery is minimally invasive and serious complications are rare. However, because the procedure involves your heart, it is essential to follow all of your doctor’s instructions to reduce the risk of problems.
What is the downside of catheter ablation?
In rare cases, catheter ablation may cause complications. For a small number of people, it may not restore a normal heart rhythm.
What Should I Expect From Catheter Ablation?
Before: How to prepare for catheter ablation
Your doctor will explain the catheter ablation procedure to you and give you a chance to ask questions. To prepare for a catheter ablation, you should:
- Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
- Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
- Tell your doctor if you have heart valve disease, as you may need to receive an antibiotic before the procedure.
- Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
- Fast for a certain time before the procedure. Your doctor will tell you how long to fast (usually overnight).
- Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.
On the day of your catheter ablation procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.
Your doctor will let you know if you will be discharged the same day or stay in the hospital overnight. If you are discharged the same day, you will need to arrange for a ride home. If you will be staying in the hospital, you should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes.
How long does catheter ablation take?
Catheter ablation usually takes 1-4 hours. If you are having other cardiac procedures at the same time, your procedure may take longer.
During your catheter ablation
You will be given medications through an IV to help you relax or put you to sleep. Your doctor will also numb the place where they will open your blood vessel, usually in your groin. After you are comfortable, your doctor will insert catheters that record electrical activity into your blood vessel and guide them to your heart.
These special catheters monitor electrical signals in your heart and deliver the energy needed to perform the ablation. Your medical team will use a computerized mapping system to help them find the source of the abnormal electrical signals in your heart.
You may feel some discomfort in your chest during the procedure, but it is not usually painful. After the ablation is complete, your doctor will remove the catheters.
Recovery after catheter ablation
After the catheters are removed, your medical team will apply pressure to your incision site for several minutes to stop the bleeding. You must remain lying down for 4-6 hours. You will also need to be still and avoid moving the limb where the catheter was inserted.
Your medical team will need to monitor your blood pressure and check the insertion site frequently. You will need to remain in the hospital for several hours, or possibly overnight. It is very important that you follow your discharge instructions and take good care of your insertion site to prevent complications.
Talk to your doctor about when you can resume normal activities or return to work. You will need to arrange for someone to drive you home after the procedure. It also is very important that you see your doctor for follow-up visits as recommended.
When to call your doctor about complications
You should call your doctor if you are experiencing any unusual symptoms, including:
- A fever of more than 100.0°F.
- Burning or pain in your chest.
- Difficulty breathing.
- Difficulty swallowing, throat pain, or bloody cough.
- New or increasing shortness of breath.
- Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
- Rapid or pounding heartbeat.
- Redness or rash on your chest or back.
- Severe pain, coldness, numbness, or discoloration in the limb where the catheter was inserted.
What’s the prognosis after catheter ablation?
Most people’s heart rhythm returns to normal after catheter ablation. However, some people may still need to take their heart rhythm medications. A small number of people may need to have another catheter ablation procedure in the future if their abnormal heart rhythm returns.
What’s the success rate of catheter ablation?
Catheter ablation has a success rate of up to 90 percent, depending on the type of ablation and arrhythmia you have. Your doctor will discuss potential success rates with you before your procedure.
Why Choose UPMC for Catheter Ablation?
UPMC physicians perform hundreds of catheter ablation procedures each year using the latest technology and techniques. If you require additional cardiovascular care, the specialists at UPMC have the skills and experience needed to perform advanced cardiovascular procedures and offer you the latest treatment options.
Last reviewed by a UPMC medical professional on 2024-10-01.