What is Cardiac Ablation?

Cardiac ablation is a procedure used for atrial fibrillation (a-fib) treatment, which is an irregular beating of the heart. Doctors may recommend the procedure when other methods of treatment such as drugs and heartbeat reset aren’t successful.

If atrial fibrillation, or an irregular heart rate, isn't treated properly it can make a victim more vulnerable to clotting of blood, heart breakdown or stroke. 

 

What are a-fib symptoms?

A-fib symptoms include:

• Extreme tiredness
• Breathing problems
• Palpitations of the heart

Generally physicians assess danger signs before prescribing treatment to a specific disease, and they may not prescribe any treatment if a patient has mild or no symptoms. However, doctors prescribe blood thinner drugs to a-fib patients for stroke prevention. 

Ablation is recommended if:

• The symptoms are so serious that they prevent the patient from performing daily activities.
• Medications and cardioversion are ineffective, or if the medications have adverse effects.
• A patient has blood clots or stroke.

Cardiac ablation can also be used for treating arrhythmias (heart rhythm issues). During ablation, a doctor inserts catheters into a patient’s groin and threads them to the heart to rectify structural cardiac issues that are responsible for arrhythmias.

Cardiac ablation works by disfiguring or damaging the cardiac tissues that cause heart rhythm issues. Sometimes, ablation interferes with the abnormal transmission of electric signals to the heart, thus stopping the abnormal rhythms.  Although ablation is sometimes performed via a one-heart surgical operation, in most cases it is carried out using catheters, thus shortening the recovery periods. The catheter method is also less invasive.

 

What goes on during cardiac ablation?

Cardiac ablations are performed in an electrophysiology laboratory. A healthcare team comprising of a cardiologist, a laboratory technician, a nurse, as well as an anesthesia administrator may be present for the procedure. The completion of the procedure takes around three to six hours. You may be given a local anesthetic drug together with a sedative to numb certain body parts or the procedure may be done while you are fully unconscious under a general anesthesia. Medication to make you drowsy and eventually fall asleep is administered through your arm’s intravenous line. Your cardiac electrical function will be monitored with a special device. 

Your physician cleans and numbs a region on your arm, neck or between your abdomen and thigh. Then several catheters are threaded into your heart via a blood vessel. In order to properly view the abnormal cardiac tissues, your cardiologist injects you with a particular contrast dye. The specialist then uses a catheter whose tip has an electrode to control a blast of radiofrequency energy. The electrical burst destroys little areas of the abnormal cardiac tissue to restore the normal heart rhythm.

Although you may feel slight pain during the procedure, ask your doctor to give you more drugs if you feel pain.

After cardiac ablation, you will be taken to a recovery room where you will stay for around five hours. While in the room, your heartbeat will be monitored as you recover. You may discharge from the hospital on the procedure day or the following day.

 

Dangers

There are some severe risks associated with cardiac ablation. They include:

• The catheter insertion site may bleed or become infected
• Blood vessel damage
• Heart puncture
• Heart valve damage
• Cardiac electrical system damage
• Clotting of blood in the legs or lungs
• Stroke
• Heart attack
• Pulmonary vein stenosis
• Kidney damage
• Loss of life (rarely)
• Dietary and lifestyle changes

Diabetic people or those having kidney disease are more vulnerable to these complications.

 

Reasons for having cardiac ablation

As the heart beats, electrical pulses that lead to its contraction should traverse your heart by following a specific route. An abnormal heart rhythm, a condition commonly referred to as arrhythmia, can occur if the impulses are interrupted in any way. Sometimes cardiac ablation can be used to treat arrhythmia.

Although ablation is not usually the first arrhythmia treatment option, it is an alternative treatment for individuals:

• Whose arrhythmia has resisted medications 
• Who have experienced severe adverse effects as a result of arrhythmia medications
• Whose arrhythmias have returned after a prior ablation
• Who are highly prone to arrhythmia complications like cardiac arrest

 

What to expect

In the course of the procedure

Prior to the commencement of the procedure, your doctor inserts an intravenous line into your arm. Then you will be given sleep-inducing medication to make you relax or unconscious. After the sedative medication becomes effective, a needle will be inserted into your groin, neck or arm, through which a sheath is then inserted into your vein. Several catheters will then be threaded to various parts of your heart via the sheath. A dye is administered through the catheter to help the doctor view your blood vessels as well as the heart through an X-ray imaging.

There are electrodes at the ends of the catheters. These electrodes send electrical bursts to the heart and record the electrical functioning of the heart during the procedure. This helps your physician to identify any unusual cardiac arrhythmia-causing tissue. After the doctor identifies the abnormal tissue causing arrhythmia, he or she targets the tips of the catheters to the region with the abnormal cardiac muscle. The energy traveling through the tips of the catheters scars and damages the harmful tissue causing arrhythmia. 

The completion of ablation normally takes around five hours, but a longer time may be required for complex procedures. You may feel slight discomfort during a cardiac ablation while the cardiologist injects the dye into the catheter or when energy is introduced through the tips of the catheters. You should let your radiologist know in case you experience serious pain or reduced breathing during the procedure.

After cardiac ablation

After cardiac ablation, you will be transferred to a recovery room where you are required to relax for about five hours to prevent the catheter insertion site from bleeding. A nurse will monitor your heart beat and blood pressure to find out if the procedure caused any complications.

Your condition will determine if you will go home on the procedure day or if you’ll need to remain in the hospital until the following day. Arrange on having a person to take you home after the procedure if you are allowed to go home immediately after the five hours in the recovery room.

You may experience slight soreness after cardiac ablation, but this issue will disappear in a week's time. Normally, you can resume your usual activities in a few days after the procedure.

Outcomes

Cardiac ablation can be very effective, but sometimes repeat procedures may be required. You may also be required to take medicines after having an ablation.

Your doctor might ask you to change your lifestyle in a way that improves your heart’s general health, particularly to avoid or help recover from conditions that lead to or aggravate arrhythmias, for instance, hypertension.  

Your doctor may ask you to:

• Abstain from taking caffeine
• Take less salt, to possibly help in lowering blood pressure
• Be more physically active
• Stop smoking
• Stop drinking alcohol
• Take a diet that is healthy for your heart
• Consistently have a healthy body weight
• Control intense emotions, like anger