Catheter ablation is a procedure that is used to destroy (ablate) areas of the heart which are causing arrhythmias. In a radiofrequency ablation, electrophysiologists pinpoint the area and then use radio wave energy to "cauterize" the tiny part of the heart muscle causing the heart rhythm abnormality. The procedure should completely eliminate your abnormal heart rhythm. Catheter ablation plays an important role in the management of most types of sustained cardiac arrhythmias. The procedure is done in the EP lab under the direction of a team of highly trained doctors, nurses, and technologists. Using X-rays as a guide, the doctor will pass several small catheters through a vein in the groin or neck and position them directly on the area that is interfering with the heart's normal electrical activity. A diagnostic EP test (described above) is always performed as part of the catheter ablation procedure to accurately diagnose the heart rhythm abnormality. If one of the many arrhythmias that are curable with catheter ablation is identified, a catheter is guided to the site of origin of the abnormal heart rhythm. RF energy is then passed through the catheters to heat the area and cause a tiny burn, which destroys the problem-causing tissue. The procedure typically lasts three to five hours. What to Expect
You should avoid eating or drinking anything after midnight the night before the study except for your normal medications, unless otherwise directed by your doctor or nurse. Once at the EP lab, a nurse will place an IV in your hand or arm so that you can receive fluids and medications. During the procedure, you will lie on a padded X-ray table. You will have a blood pressure cuff on your arm, a clip on your finger to make sure you are getting enough oxygen, and wires on your legs and arms to check your heart rate. The nurse will give you pain medication and a sedative. The amount of sedation is adjusted for patient comfort. Most patients sleep throughout the entire procedure. The area of your chest and groin where the doctor will be working will be cleaned and shaved and you will be covered with sterile drapes from your shoulders to your feet. The doctor will give you a shot to numb the area where the catheters will be inserted. During the procedure, you will lie on a padded X-ray table. You will have a blood pressure cuff on your arm, a clip on your finger to make sure you are getting enough oxygen, and wires on your legs and arms to check your heart rate. The nurse will give you pain medication and a sedative. The amount of sedation is adjusted for patient comfort. Most patients sleep throughout the entire procedure. The area of your chest and groin where the doctor will be working will be cleaned and shaved and you will be covered with sterile drapes from your shoulders to your feet. The doctor will give you a shot to numb the area where the catheters will be inserted. Once the catheters are in position, the doctor will use them to pinpoint the faulty tissue. Then the RF energy is used to destroy the tissue. Once the area of the heart muscle is "knocked out," the catheters will be removed and pressure will be applied to the area to stop any bleeding. After the procedure, you need to rest in bed for three to six hours without bending your leg. After two hours, the head of your bed may be raised a little. Your nurse will take your blood pressure regularly, check the area where the wires were, and monitor your heart rhythm. You may experience soreness as the anesthetic wears off, so do not hesitate to ask for pain medication. Tell your doctor or nurse immediately if you notice bleeding, swelling or discomfort in the area where the catheters were inserted. Most catheter ablation procedures are performed on an outpatient basis. However, depending on the specific procedure and the time the procedure is performed, you may spend one night in the hospital. Avoid heavy lifting or excessive exercise for one day after the procedure. RF catheter ablation is a safe therapy; however, any procedure carries small risks. These risks will be reviewed with you before the procedure.
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