Your heart normally beats in a steady rhythm controlled by electrical signals. Sometimes extra electrical pathways or irritable areas cause your heart to beat too fast or irregularly—conditions like atrial fibrillation, ventricular tachycardia atrial flutter, or supraventricular tachycardia. While medications can control these rhythms, they don’t cure them and must be taken daily. Radiofrequency ablation offers a permanent solution by heating the abnormal tissue causing the problem.
Overview
Radiofrequency ablation fixes abnormal heart rhythms by heating problematic tissue. A special catheter delivers radiofrequency energy—high-frequency electrical current—that heats the catheter tip to about 50-60°C (122-140°F), hot enough to destroy heart tissue.
The heating is very controlled and precise. Each application lasts 30-60 seconds and creates a small scar about the size of a pencil eraser. The destroyed tissue can’t conduct electricity, blocking the abnormal signals that were causing rhythm problems.
Radiofrequency ablation has been used for decades and works for virtually all types of abnormal rhythms including atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardia. Success rates are excellent—often curing problems in 85-98% of cases depending on the specific rhythm.
The procedure takes 2-4 hours. You’re sedated or under general anesthesia, so you don’t feel anything. Most people go home the next day and return to normal activities within a week. Many never need rhythm medications again.
The Procedure
You’re brought to the electrophysiology lab—a specialized room with X-ray equipment and monitoring systems. An IV line is placed and you’re given sedation or put under general anesthesia.
Small punctures are made in veins in your groin or neck. Thin, flexible catheters are inserted and threaded through blood vessels to your heart using X-ray guidance. You don’t feel catheters moving through vessels.
Mapping catheters record electrical activity from inside your heart chambers. Advanced 3D mapping systems create detailed electrical maps showing exactly where abnormal signals originate. These maps look like colorful pictures of your heart’s interior showing which areas fire signals too early or too rapidly.
Sometimes doctors need to trigger your abnormal rhythm artificially to see precisely what’s happening and where it’s coming from.
Once the problem area is identified, the radiofrequency ablation catheter is positioned at that exact spot. Radiofrequency energy flows through the catheter tip, heating it to 50-60°C. The tissue in contact with the tip heats up and is destroyed.
You typically don’t feel the heating, though some people experience brief warmth or mild discomfort during applications. Each heating application lasts 30-60 seconds. The tissue turns white as it’s heated, showing doctors the scar is forming.
For some rhythm problems, just one or two spots need treatment. For others, like atrial fibrillation, doctors create long lines of scar tissue by heating many points in sequence. Eventually these individual scars connect into continuous lines that block abnormal signals. Creating these lines might require 20-40 individual heating applications.
During the procedure, doctors continuously monitor temperature, electrical signals, and how much energy is being delivered. This ensures they destroy enough tissue to fix the problem without damaging surrounding structures.
After ablation is complete, doctors test your heart’s electrical system. They try to trigger the abnormal rhythm again—if they can’t, the ablation succeeded. Sometimes they pace your heart at different speeds to make sure everything works normally.
The catheters are removed. Pressure is applied to the puncture sites for 10-20 minutes to stop bleeding. Small bandages are placed over the sites.
You’re moved to a recovery area for monitoring. You must lie relatively flat for several hours to prevent bleeding from the puncture sites. Most people stay overnight and go home the next day.
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Reference: Radiofrequency Ablation
