Cardiac Ablation

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Cardiac Ablation

Cardiac Ablation is a procedure that involves the use of energy for making small scars in the tissues of your heart. The energy stops unusual electrical signals that are moving through the heart and causing uneven heartbeat or arrhythmia. The procedure treats atrial fibrillation which is a type of irregular heartbeat. Your doctor will perform Cardiac Ablation if the medications and heartbeat resetting (also called cardioversion) fail to work.

Types of Cardiac Ablation

There are two ways of performing ablation. Catheter ablation is a more common one of the two. The other name for Cardiac Ablation is radiofrequency or pulmonary vein ablation. This isn’t a surgical procedure. Your doctor will put a catheter (a thin, flexible tube) into the blood vessels of your neck or leg to guide it to the heart. When the tube reaches the area causing arrhythmia, it will destroy the cells responsible for the same. This makes your heartbeats regular.

  • Radiofrequency ablation- The doctor will send radiofrequency energy with the help of catheters to make circular scars around the veins or each group of veins.
  • Cryoablation- The doctor will use a single catheter to send a balloon that has material tipped for freezing the tissues and cause a scar.

 

Types of cardiac surgical ablation : Surgical ablation will involve cutting your chest to gain access.

  • Maze procedure- Your doctor will perform this while you are undergoing open-heart surgery for bypass or valve replacement. He or she will make small cuts in the upper portion of your heart while stitching them together to form a scar that stops unusual signals.
  • Mini maze- In most cases, people with atrial fibrillation don’t require n heart surgery. Here the need for this procedure arises. Your doctor will make multiple cuts between the ribs while using a camera to perform catheter ablation.
  • Convergent procedure- It involves catheter ablation with a mini-maze procedure.

Why it's done?

The procedure helps to correct the problems with heart rhythm. The electrical impulses causing the contraction of your heartbeats must follow a specific pathway through the heart. Arrhythmia or abnormal heartbeat happens due to an interruption in these impulses that are treatable with Cardiac Ablation. Cardiac Ablation is the right option for those who:

  • Tried medications for arrhythmia but didn’t get any results
  • Had serious side effects because of medications that treat arrhythmia
  • Are at a high risk of complications due to arrhythmia

Benefits

You might need Cardiac Ablation if you have severe symptoms of atrial fibrillation because they make it difficult for you to perform routine activities. Your doctor will consider all the factors before recommending this procedure for you.

Preparation

Your doctor will examine you and recommend several tests for evaluating the condition of your heart. He or she will discuss the benefits and risks of the procedure. You might need to stop drinking and eating a night before the procedure. Inform your doctor about the medications that you are taking and if you need to stop them temporarily. Your doctor will give you special instructions that you must follow before and after the procedure. You might need to stop certain medications days before the procedure. You may also need to take special precautions if you have a heart device implanted in your heart like an implantable cardioverter-defibrillator or pacemaker.

What to expect?

During the procedure

Your doctor will perform the procedure in the hospital. The nurse will place an IV line in your forearms before beginning the procedure and give you a sedative so that you relax. Your doctor might use general anesthesia instead to make you fall asleep. Your doctor will numb the area near your neck, groin, or forearm after the effects of the sedative set in. The team will then insert a needle into your vein while placing a sheath through this needle.

This is followed by threading the catheters through your sheath and guiding them to various places in your heart. Next, they will inject a dye into the catheter that allows your doctors to see the blood vessels and heart using x-ray imaging. Electrodes are present at the tip of the catheters that help to send electrical impulses to your heart and record the electrical activities of your heart. This process involving tests and imaging for determining the cause of arrhythmia is known as electrophysiology study (EP study). The doctors perform this before Cardiac Ablation to check the most effective way of treating arrhythmia.

Upon identifying the abnormal heart tissue responsible for causing heart arrhythmia, your doctor will direct the catheter tips towards the abnormal tissue of your heart. The catheter tips will allow the energy to create scars and destroy the tissue causing the arrhythmia. Ablation might block electrical signals traveling through the heart so that the abnormal rhythm stops while allowing signals to travel in a normal pathway. The procedure takes around 4 to 5 hours but it may take longer if the procedure is complex.

After the procedure

The nurse will move you to a recovery area so that you can rest quietly for 5 to 6 hours and there is no bleeding at the catheter site. The team will monitor your heartbeat and blood pressure to check if there are any complications. You can go back home on the same day as the procedure if you are in a good condition. However, you may need to stay overnight if your case is complex. Although you may experience soreness, it will hardly last a week. You will also be able to perform routine activities after some days of the procedure.

Results

You might need to take medications after the procedure. Your doctor will ask you to make lifestyle changes to improve the overall health of your heart. This helps to prevent or treat conditions causing the arrhythmia or responsible for worsening the same. You might have to use less salt and eat healthy foods. You will have to increase your physical activity and maintain a healthy weight. You must also avoid smoking or drinking alcohol.

Risks

The risks associate with Cardiac Ablation are:

  • Bleeding on the site of insertion of a catheter
  • Infection
  • Arrhythmia due to damage to the electrical system of your heart
  • Damage to your heart
  • Narrowing of the veins present between the heart and the lungs
  • Radiation
  • Damaged heart valves
  • Damage to the blood vessels due to scraping
  • Radiation
  • Heart attack
  • Blood clots in your lungs or legs
  • Kidney damage because of the dye
  • Stroke
  • Death

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