Cardiac ablation is a procedure that is used to scar small areas in your heart that may be involved in your heart rhythm problems. This can prevent the abnormal electrical signals or rhythms from moving through the heart.
During the procedure, small wires called electrodes are placed inside your heart to measure your heart's electrical activity. When the source of the problem is found, the tissue causing the problem is destroyed.
There are two methods for performing cardiac ablation:
Radiofrequency ablation uses heat energy to eliminate the problem area.
Cryoablation uses very cold temperatures.
The type of procedure you have will depend on what kind of abnormal heart rhythm you have.
Cardiac ablation procedures are done in a hospital laboratory by trained staff. This includes cardiologists (heart doctors), technicians, and nurses. The setting is safe and controlled so your risk is as low as possible.
You will be given medicine (a sedative) before the procedure to help you relax.
The skin on your neck, arm, or groin will be cleaned well and made numb with an anesthetic.
Next, the doctor will make a small cut in the skin.
A small, flexible tube (catheter) will be inserted through this cut into one of the blood vessels in the area. The doctor will use live x-ray images to carefully guide the catheter up into your heart.
Once the catheter is in place, your doctor will place small electrodes in different areas of your heart.
These electrodes are connected to monitors that allow the cardiologist to tell what area in your heart is causing problems with your heart rhythm. In most cases, there are one or more specific areas.
Once the source of the problem has been found, one of the catheter lines is used to send electrical (or sometimes cold) energy to the problem area.
This creates a small scar that causes the heart rhythm problem to stop.
Catheter ablation is a long procedure. It can last 4 or more hours. During the procedure your heart will be monitored closely. A health care provider may ask you if you are having symptoms at different times during the procedure. Symptoms you may feel are:
You will most often be asked not to drink or eat anything after midnight the night before your procedure.
Take the drugs your provider has told you to take with a small sip of water.
You will be told when to arrive at the hospital.
After the Procedure
Pressure to reduce bleeding is put on the area where the catheters were inserted into your body. You will be kept in bed for at least 1 hour. You may need to stay in bed for up to 5 or 6 hours. Your heart rhythm will be checked during this time.
Your doctor will decide whether you can go home on the same day, or if you will need to stay in the hospital overnight for continued heart monitoring. You will need someone to drive you home after your procedure.
For 2 or 3 days after your procedure, you may have these symptoms:
Achy feeling in your chest
Skipped heartbeats, or times when your heartbeat is very fast or irregular.
Your doctor may keep you on your medicines, or give you new ones that help control your heart rhythm.
Success rates are different depending on what type of heart rhythm problem is being treated.
Calkins H, Brugada J, Packer DL, Cappato R, Chen SA, Crijns HJ, et al. (HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow-up. A report of the Heart Rhythm Society (HRS) Task Force on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2007:4(6):816-61.
Lustgarten DL. History of cardiac cryosurgery and cryoablation. In: Bredikis AJ, Wilber DJ, eds. Cryoablation of Cardiac Arrhythmias. Philadelphia, PA: Elsevier Saunders; 2011:chap 1.
Miller JM, Zipes DP. Therapy for cardiac arrhythmias. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 35.
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.