Cardiac Ablation: Types, Risks, Benefits, Procedure

Medically Reviewed by Dr. K on 19 April 2021

Cardiac Ablation

What Is Cardiac Ablation?

This method utilizes energy to create tiny scars in the tissue of your heart. They block abnormal electrical signals that travel through your heart and trigger an irregular heartbeat (your doctor might call it arrhythmia). Atrial fibrillation (AF), a form of irregular heartbeat, may also be treated with cardiac ablation. If this is the case, your doctor can refer to the procedure as atrial fibrillation ablation.

If medications and resetting the heartbeat, also known as cardioversion, do not function, the doctor can try cardiac ablation.

Types of Cardiac Ablation

Your doctor will perform ablation in two ways. The most usual treatment is catheter ablation.

Types of cardiac catheter ablation

Catheter ablation, also known as radiofrequency ablation or pulmonary vein ablation, is not a surgical procedure. Your doctor inserts a small, flexible tube called a catheter into a blood vessel in your leg or neck and directs it to your heart. When it enters the region causing the arrhythmia, it has the ability to kill those cells. This aids in restoring the heartbeat’s regularity. There are two types:

  • Radiofrequency ablation. The doctor utilizes catheters to deliver radiofrequency energy (similar to microwave heat) to each vein or group of veins, which creates circular scars around each vein or group of veins.
  • Cryoablation. A single catheter delivers a balloon containing a material that freezes the tissues, causing a scar.

Types of cardiac surgical ablation

Surgical ablation helps make a cut in your stomach. There are three major types:

  • Maze procedure. This is normally done when you are undergoing open heart surgery for another concern, such as a bypass or valve replacement. They make tiny incisions in the upper part of your heart and stitch them together to form scar tissue that prevents abnormal heart signals.
  • Mini maze. The majority of people with AF do not need open heart surgery. This is where the less intrusive type takes place. To perform catheter ablation, the doctor makes some tiny cuts between your ribs and utilizes a camera. Some hospitals have robotic-assisted surgery, which helps with smaller incisions and a more accurate operation. A video camera or a tiny robot will be implanted in your chest by your doctor. It will guide the formation of scar tissue, which may aid in the regularity of your heartbeat.
  • Convergent procedure. Catheter ablation is combined with a mini maze in this procedure. The doctor uses radiofrequency ablation to treat the pulmonary vein, and a surgeon makes a small incision under your breastbone to treat the outside of your heart with radiofrequency energy.

Risks of Cardiac Ablation

Any operation carries some risk. Cardiovascular ablation complications may include the following:

  • Bleeding or infection where the catheter went in
  • Damaged blood vessels if the catheter scrapes them
  • Arrhythmias caused by damage to your heart’s electrical system
  • Blood clots in your legs or lungs
  • Heart damage, like punctures or damaged valves
  • Stroke or heart attack
  • Narrowing of the veins between your lungs and heart
  • Kidney damage from the dye
  • Radiation
  • Death

What Are the Benefits of Ablation?

Without treatment for AF, the risk of blood clots, heart failure, or stroke increases. These are potentially fatal.

Before recommending medication, the doctor will consider the risk factors. If you have no symptoms or just have mild ones, the doctor can decide to monitor and wait. However, they can prescribe warfarin or another blood thinner to prevent strokes.

Cardiac ablation could be a good choice for you if your AF symptoms are serious and make everyday activities difficult.

Which Type of Cardiac Ablation Is Right for Me?

Your doctor will discuss AF treatment options with you, including ablation. The method will be determined by the following:

  • The causes of your AF
  • If you are experiencing symptoms
  • Your risk of developing heart disease

Different forms of ablation are used to reach particular areas of your heart. You may be able to return home the next day, or you may need to stay in the hospital for one night or longer.

Although medications may be used to treat AF and maintain a normal heart rhythm, they can cause side effects or stop working after a while. The next step could be cardiac ablation. This treatment can prolong the duration of the AF or even cure it.

Many people with AF benefit from nonsurgical and minimally invasive ablation. If the first procedure is unsuccessful, a second is often successful. With those options, you’ll be able to easily recover and resume your normal routine.

How Do You Prepare for Ablation?

Your medical staff should most certainly advise you to:

  • The night before the operation, refrain from eating or drinking.
  • Several days before, discontinue all drugs used to treat arrhythmia.
  • Consult the doctor to determine if you can discontinue any other drugs.
  • Consult with your doctor about precautions if you have a pacemaker or an implanted defibrillator.

The doctor will provide you with any further guidance.

What to Expect During Cardiac Ablation

A member of the medical staff will insert a needle into your forearm or hand, which will be connected to an IV thread. They’ll use it to administer a sedative, which will help you relax, or general anaesthesia, which will put you to sleep.

Your doctor will numb an area near a vein in your groin, throat, or forearm if you’re getting catheter ablation. They’ll insert a needle into the vein and thread a thin tube known as a sheath through it. Catheters pass through this sheath and into the veins, ultimately leading to the heart. Your doctor may use electrodes or dye to ascertain the source of your arrhythmia and to eliminate abnormal tissue.

It’s possible that you’ll experience some mild discomfort. If you have extreme pain or shortness of breath, notify the medical team.

Surgical ablation is a more difficult procedure. Your doctor will cut down the middle of your chest and separate your breastbone during a maze procedure. To keep your blood pumping, they’ll connect you up to a heart-lung bypass machine. The ablation devices will be inserted into one or more minor cuts in your chest for the other styles.

Cardiac ablation typically takes 3 to 6 hours, but it can take longer depending on the situation.

What to Expect After Cardiac Ablation

What is recovery like?

It is dependent on the treatment you are undergoing:

Catheter ablation. While you will need to spend the night in the hospital, most people are able to return home the next day. If that’s the case, you’ll spend a few hours in a recovery room while a nurse monitors your heart rate and blood pressure. To avoid bleeding from where your skin was cut, you must lie flat and still. Make arrangements for someone to bring you home.

A prescription to avoid blood clots and another to prevent AF would be prescribed by the doctor. You’ll most likely have them for two months. When you’ve arrived at your destination, take a shower, but keep the water cold. For the next 5 days, or before the cuts have healed, don’t take a bath, swim, or soak.

During the first week:

  • Lifting more than 10 pounds is not recommended.
  • Do not engage in tasks that require you to push or pull heavy objects, such as lifting heavy objects or doing strenuous activities.
  • Stop and rest if you get tired.
  • Do not engage in any physical activity. In week two, you can resume your daily routine.

Maze procedure. You’ll probably spend about a week in the hospital. You’ll spend the first few days in an intensive care unit (ICU) before being transferred to a normal room and eventually going home. It will take 6 to 8 weeks for you to fully recover, but you should be able to resume everyday activities in 2 to 3 weeks. In about four weeks, you should start to feel better. For around three months, you’ll most likely be on a blood thinner.

Mini maze. You’ll spend a few hours to a day in the ICU. You’ll most likely stay for two to four days in total.

Open-heart maze. This is a big operation. You’ll be in intensive care for a day or two, and you could be in the hospital for up to a week. You’ll feel exhausted and have chest pain at first. You should be able to return to work in about three months, but it could take up to six months to get back to normal. Once you’ve arrived at your house:

  • You would need someone to drive you around for a while. The doctor will inform you when you will be able to drive again.
  • At home, you’ll almost certainly need assistance.
  • The stitches will need to be removed in about ten days.
  • For a few weeks, avoid lifting anything heavy or doing strenous activities.

Convergent procedure. This normally necessitates a two- to a three-day hospital stay. The recovery process is close to that of catheter ablation.

Life after cardiac ablation

Catheter ablation will not cure your AF, but it will usually relieve your symptoms. Since it takes three months for the scars to develop, you will also have AF episodes during the first three months.

Possibly you would need another treatment to keep your heartbeat normal if you’ve had AF for a long time. You will also require medication for a few months after the operation to stabilise your heart rhythm.

The majority of people who undergo the maze treatment experience long-term relief from their symptoms. Many people may not need to take heart rhythm medication afterward.

Your doctor may advise you to make certain lifestyle changes to keep your heart safe, such as:

  • Consume a balanced diet that is low in salt and alcohol.
  • Stop smoking.
  • Maintain a healthy weight.
  • Increase your physical activity.
  • Stress and heavy feelings should be controlled as much as possible.

Sources

Referenced on 14/4/2021

  1. Stop AF.org: “Maze Procedure: (Surgical Ablation),” “What to Expect After Cardiac Ablation,” “What to Expect After a Maze Procedure,” “What to Expect After Mini Maze Surgery.”
  2. Keck School of Medicine of USC: “Robotic-Assisted Maze Surgery.”
  3. Frankel Cardiovascular Center, Michigan Medicine: “Frequently Asked Questions: Catheter Ablation.”
  4. Inova Heart and Vascular Institute: “Frequently Asked Questions.”
  5. Johns Hopkins Medicine: “Atrial Fibrillation Surgery.”
  6. Lahey Hospital & Medical Center: “Convergent Procedure.”
  7. National Heart, Lung, and Blood Institute: “Catheter Ablation.”
  8. American Heart Association: “What is Atrial Fibrillation (AF or AF)?” “Non-surgical Procedures for Atrial Fibrillation (AF or AF),” “Treatment Guidelines of Atrial Fibrillation (AF or AF),” “Why Atrial Fibrillation (AF or AF) Matters,” “Ablation for Arrhythmias,” “Surgical Procedures for Atrial Fibrillation (AF or AF).”
  9. Cleveland Clinic: “Surgical Procedures for Atrial Fibrillation (MAZE),” “After Catheter Ablation,” “Heart Surgery for Atrial Fibrillation (MAZE): After the Procedure.”
  10. Heart Rhythm Society: “Symptoms of Atrial Fibrillation (AF),” “Types of Ablations.”
  11. University of Southern California Keck School of Medicine: “MAZE Procedure for Treatment of Atrial Fibrillation.”
  12. Verma, A. Circulation, published August 2005.
  13. Mayo Clinic: “Atrial Fibrillation: Symptoms,” “Atrial fibrillation ablation,” “Cardiac ablation.”
  14. Heart and Stroke Foundation of Canada: “Ablation.”
  15. https://www.webmd.com/heart-disease/atrial-fibrillation/what-is-cardiac-ablation

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