Patient education: Catheter ablation for the heart (The Basics)

What is catheter ablation? — 

This is a procedure to treat certain conditions that cause the heart to beat too fast. A catheter is a wire that delivers energy to destroy an area of heart tissue that is creating or spreading abnormal electrical signals.

Types of ablation include:

●"Radiofrequency catheter ablation" ("RFA") – Doctors use a catheter to deliver radio waves that heat and destroy tissue.

●"Cryothermal ablation," also called "cryoablation" – Doctors use a catheter to freeze and destroy tissue.

●"Pulsed field ablation" ("PFA") – Doctors use a catheter to deliver very short bursts of electrical energy to destroy tissue.

How do normal heartbeats happen? — 

A normal heartbeat happens when an electrical signal starts in 1 spot near the top of the heart. The signal follows a path to spread across the heart. As it spreads, it causes the heart muscle to squeeze. Each time the heart squeezes ("beats"), blood is sent all over the body. Normally, the heart beats in a regular way, with a typical range of 60 to 100 times a minute.

What can make the heart beat too fast? — 

The heart can beat too fast when the electrical signal:

●Starts in the wrong part of the heart

●Follows the wrong path as it spreads across the heart

People with heart problems, as well as those with healthy hearts, can have heartbeats that are too fast. The doctor might have had you do an "electrophysiology" ("EP") study to figure out where the fast heartbeats are coming from (figure 1).

How does catheter ablation work? — 

Catheter ablation destroys the part of the heart that is creating or spreading abnormal electrical signals. After the procedure, the heart can beat normally again.

How do I prepare for catheter ablation? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

You might be asked to:

●Temporarily stop certain medicines

●Avoid eating or drinking for some amount of time

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during catheter ablation? — 

When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines to make sure you do not feel pain and can relax and remain still during the procedure.

●The doctor will make a small cut (incision) in your skin, usually in your upper leg or in your arm. They will insert a thin wire called a "catheter" into the incision and into a blood vessel.

●They will guide the catheter into your heart. They might use X-rays or ultrasound to make sure it goes into the right place.

●Using the tip of the catheter, they will try to destroy the small parts of your heart causing the fast heartbeat.

●When finished, they will remove the catheter. They will hold pressure or use stitches, skin glue, or medical tape to close your incision and stop any bleeding. They will cover the area with a clean bandage.

What happens after catheter ablation? — 

The staff will watch you closely as your anesthesia wears off. You can probably go home the same day, but you need someone else to bring you home.

Your doctor or nurse will tell you when to restart any medicines you stopped. They will also tell you if there are any activities you should avoid.

What are the risks of catheter ablation? — 

Your doctor will talk to you about all the possible risks and answer your questions. Possible risks include:

●Bleeding, bruising, or getting an infection where the catheter was put in

●Damage to the heart from the wires

●Damage to the veins from the lungs, esophagus (the tube that goes from the mouth to the stomach), or the nerve that controls breathing

●Changes in the heartbeat – Some people who have changes in their heartbeat might need to get a pacemaker. This is a device that can keep the heartbeat at a normal rate. The pacemaker is placed under the skin of the upper chest. It has wires that connect to the heart.

●Blood clots forming and traveling to the brain or lungs

●The procedure not working – If so, your doctor will recommend other treatment.

Is catheter ablation the only treatment for a fast heartbeat? — 

No. Doctors can use other treatments for a fast heartbeat. These can include medicines, another catheter ablation, or surgery.

More on this topic

Patient education: Catheter ablation for the heart – Discharge instructions (The Basics)
Patient education: Atrial fibrillation (The Basics)
Patient education: Wolff-Parkinson-White syndrome (The Basics)
Patient education: Pacemakers (The Basics)

Patient education: Catheter ablation for abnormal heartbeats (Beyond the Basics)
Patient education: Pacemakers (Beyond the Basics)
Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics)
Patient education: Atrial fibrillation (Beyond the Basics)