Cardiac ablation is a treatment for irregular heartbeats, known as arrhythmias. Heat or cold methods are used to treat these conditions, which are caused by issues in the heart’s electrical system. Using specially designed catheters to precisely target and treat the damaged heart tissue responsible for irregular electrical signals.
The heat method (radiofrequency ablation) burns problematic tissue, while the cold method (cryoablation) freezes it. Both approaches are minimally invasive and performed through small incisions, allowing patients to typically return home within 24 hours. The procedure effectively restores normal heart rhythm in most cases, significantly improving patients’ quality of life.
Arrhythmias, are significant health issues caused by irregularities in the heart’s electrical system. These conditions can severely impact quality of life, leading to symptoms such as palpitations, dizziness, fainting, and shortness of breath. If untreated, arrhythmias can result in severe health complications. Ablation therapy offers a modern solution by targeting the source of these problems and, in most cases, providing a permanent fix.
The procedure is typically performed by accessing a vein through the groin, neck, or occasionally beneath the collarbone. Catheters are advanced to the heart through this vein and are used both to pinpoint the source of the arrhythmia and to deliver the treatment. Advanced mapping systems provide detailed images of the heart’s electrical activity, ensuring that treatment is precisely focused on the problematic areas. This high level of precision preserves surrounding healthy tissues and ensures the procedure is performed with great accuracy.
What Is Cardiac Ablation?
Ablation, by definition, means “removal or destroying.” In cardiology, it refers to a method used to treat arrhythmias by eliminating specific tissues in the heart that cause these irregularities.
This procedure is performed using specialized catheters. Abnormal tissues are neutralized by applying either radiofrequency (heat) or cryoablation (cold) through these catheters. The choice of method depends on the type of arrhythmia and the patient’s overall condition, as determined by the physician. These methods include:
Radiofrequency Ablation (RF): This is the most commonly used type of ablation, where heat is applied between 50°C and 70°C to target tissues and eliminate abnormal electrical pathways in the heart.
Cryoablation: This involves applying extreme cold, ranging from -50°C to -70°C, for freezing and neutralize abnormal electrical pathways in the heart.
Although ablation is often performed on patients who do not respond adequately to medication or are at risk of serious complications, advancements in technology have made it a treatment that is increasingly considered as a first-line therapy or an early option in many cases.
In this video I have tried to give basic information about ablation.
How Is Cardiac Ablation Performed?
Cardiac ablation is typically performed under local anesthesia or sedation. Thin catheters are inserted through a vein in the groin, neck, or arm to reach the heart. Before the procedure begins, an electrophysiological study is conducted to map the heart’s electrical activity and pinpoint the areas causing the arrhythmia. Once the target areas are identified, the abnormal tissues generating irregular electrical signals are treated using heat or cold to burn or freeze them.
During the procedure, the heart’s rhythm is continuously monitored. Once the ablation is successfully completed, an additional electrophysiological study is performed to ensure that the arrhythmia is no longer triggered. If no arrhythmia is detected, the procedure is concluded, and the catheters are removed. The duration of the procedure can vary depending on the type of arrhythmia and the size of the affected area, typically lasting between 30 minutes and 2 hours.
Most patients are discharged within a day after the procedure, and the full recovery process generally takes a few days to a few weeks. It is recommended to avoid heavy exercise and intense physical activities during the first week. Post-procedure symptoms such as chest discomfort, palpitations, or shortness of breath may occur but are usually temporary and resolve within a few days.
What Are the Benefits of Cardiac Ablation?
The most significant benefit of ablation is the potential for long-term relief from symptoms such as palpitations, dizziness, fainting, and shortness of breath, which are caused by arrhythmias. This treatment significantly improves the quality of life for patients, helping them participate in daily activities with more ease. Particularly for patients who experience recurrent attacks, cardiac ablation allows them to feel more energetic and free.
Cardiac ablation directly targets the underlying cause of the arrhythmia and offers a more definitive solution than medication. Another key advantage of ablation is the potential reduction in the use of antiarrhythmic drugs. While some arrhythmias can be controlled with medication, these drugs may lead to side effects or interactions with other medications. Successful ablation can reduce or even eliminate the long-term need for medication.
What Are the Risks of Cardiac Ablation?
Although it is a minimally invasive procedure, cardiac ablation carries some small risks. Mild bleeding, bruising, or infection may occur at the site where the catheter is inserted. In rare cases, more serious complications such as damage to blood vessels or the normal components of the heart’s conduction system may arise. However, these risks are minimized through the experience of the electrophysiologist and the use of advanced imaging technologies during the procedure.
FAQs About Cardiac Ablation
Is the patient put to sleep during ablation?
For ablations performed for SVT, WPW, or AT (atrial tachycardia), the patient is not put to sleep – only local anesthesia is used. For atrial fibrillation or VT ablations, the patient is generally put to sleep or under deep sedation.
What is the success rate of ablation?
Ablation offers a permanent solution for many patients. The success rate varies depending on the type of arrhythmia and the patient’s individual situation. For most cases of SVT, the success rate is around 99%. For atrial fibrillation, the success rate in the first year is about 85-90%. Over time, the risk of recurrence increases. For ventricular arrhythmias, the recurrence rate depends on the location of the arrhythmia; some cases have a success rate of 95%, while others may have around 80%.
What should life be like after an ablation?
After ablation, it is important to adopt a healthy lifestyle. If you drink alcohol, it should be avoided. If you smoke, it is crucial to quit. Regular exercise helps maintain heart health. If you have a weight problem, aim to achieve your ideal weight. Additionally, if you have other conditions like hypertension or diabetes, they should be managed and monitored regularly. These lifestyle changes can enhance the success of the ablation and improve overall health.
Will medication be needed after ablation?
The need for medication after ablation depends on the patient’s overall health, the type of arrhythmia, and associated risk factors. Some patients may be able to stop using medication entirely, while others may need to continue with lower doses.
If you had an ablation for SVT, you usually will not need antiarrhythmic medication afterward. If you had an ablation for atrial fibrillation, you may need to take blood thinners for at least 3 months or possibly for life, depending on your risk level. Your doctor may also recommend rhythm-control medication for a period of time.
If you had successful ablation for VES or premature atrial contractions and do not have underlying heart disease, you typically won’t need antiarrhythmic medication.
Can I exercise after ablation?
Regardless of the type of ablation, if you have serious structural heart disease, you should avoid competitive sports. If you had an ablation for SVT, you can engage in any sport at your discretion. If you had an ablation for atrial fibrillation or atrial flutter, exercise is highly recommended. For VT or VES ablation, if you do not have significant structural or electrical heart disease, you can exercise. However, if you have such conditions, follow your doctor’s advice.
What should be done after ablation?
- Monitor for signs of bleeding or infection at the site of the procedure.
- Avoid heavy lifting and strenuous activities for the recommended period (usually 1-2 weeks).
- Take prescribed medications regularly.
- Seek immediate medical attention if symptoms such as fever, chest pain, or shortness of breath occur.
- Attend regular follow-up appointments.
- Be aware that temporary arrhythmias may occur in the first few months.
- Make healthy lifestyle changes, including diet, exercise, and stress management.
Reference: Ablation