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An electric impulse from within the heart causes the series of contractions which, in turn, cause the heart to beat. In some individuals the electric system does not work properly. The abnormality can cause an arrhythmia, or abnormal heartbeat. This sometimes occurs due to extra tissue, which creates an extra pathway for electrical activity. Catheter ablation is a procedure performed to correct the electrical problem and treat certain arrhythmias.
The ablation destroys the extra tissue or source of the abnormal electrical activity causing the arrhythmia. A catheter inserted into the heart directs energy to the extra tissue and destroys it. The energy source is often radiofrequency current.
Catheter ablation is often used to treat several types of genetic conditions which cause arrhythmias, such as Wolff Parkinson-White Syndrome. In this condition, an extra pathway develops which sends an electrical signal from the atrium to the ventricles and results in an abnormal heartbeat. An ablation may also be performed to treat individuals who have chronic arrhythmias, such as atrial fibrillation.
To determine if a patient is a candidate for catheter ablation, a physician will review the patient’s medical history and complete a physical exam. This will help determine if any other existing medical conditions may prevent an ablation from being performed. Usually an echocardiogram and EKG will be performed to locate what part of the heart the arrhythmia is originating from.
Usually a catheter ablation is done while the patient is awake; however, medication which causes relaxation is often given. Catheters are inserted through major arteries, such as the femoral artery in the groin. They are threaded up to the heart. One catheter usually has a camera to allow visualization of the heart. Another catheter will deliver the radiofrequency current to the tissue or part of the heart responsible for the arrhythmias.
As with most procedures involving the heart, there are some risks with catheter ablation. Excess bleeding can occur at the site the catheter was inserted. Blood clots can occasionally occur, as well as an infection. Rarely, the artery in which the catheter was inserted can become damaged. Pericarditis, which is an inflammation of the heart sac is also a rare complication.
Recovery time may vary depending on an individual's age and general health. After the procedure, patients will need to be observed for several hours to watch for any arrhythmias or excess bleeding. Patients without complications may be discharged the same day of the procedure or kept overnight for continued monitoring. Although it’s essential to follow the recommendations of the physician, most patients can resume regular activities in a few days.
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