Catheter Ablation: Procedure, Risks, Benefits, Recovery, Costs

Medically Reviewed by Dr. K on 19 April 2021

Table of Contents :

  1. Catheter Ablation 
  2. How to Prepare
  3. What to Expect
  4. Radiofrequency Ablation vs. Cryoablation
  5. After Procedure
  6. Recovery
  7. Risks of Procedure
  8. Benefits and Success of Procedure
  9. Costs

 

Catheter Ablation 

Catheter ablation is a procedure used to treat heart arrhythmias such as atrial fibrillation (AF), atrial flutter, or supraventricular tachycardia (SVT). It eliminates the tissue that is causing the pulse to become irregular. This results in the formation of scar tissue inside the heart. This scar tissue is beneficial. It will assist in maintaining the rhythm of your heartbeat.

A cardiologist (a doctor who specialises in heart disease) would not need to make an incision in your chest to perform this operation. They use a catheter, which is a long, flexible tube that is inserted into a blood vessel and directed to your heart. The catheter delivers energy directly to the area of your heart triggering the irregular heart rhythm.

How To Prepare

Your doctor may request that you undergo some tests prior to your procedure. They will provide your doctor with more information about your heart and general health. They may include the following:

You should not eat or drink anything after midnight the day before your ablation. You can have a bad reaction to the anaesthesia if you have food or drinks in your stomach during the operation. For instance, it could cause you to vomit, which may cause contents to enter your lungs.

What to Expect: Catheter Ablation Step by Step

  1. A nurse will measure your weight, perform a physical examination, obtain your medical records, inquire about all medications you are currently taking, and check your blood test results for blood thinner levels.
  2. Additionally, the anesthesiologist will examine you, inquire about your medical history, and discuss your treatment for the ablation with you.
  3. You will be sedated during the ablation. It is a relatively painless operation
  4. Your ablation will take place when you are lying on a surgical table.
  5. Your back and chest will be patched with electrocardiogram (ECG) electrodes. The electrodes' wires will transmit signals to machines, which will direct your doctor during the ablation.
  6. If you have hair on your skin, the nurse might shave the area where the catheter tube will be inserted. It normally enters through a blood vessel in your groin at the top of your thighs, or sometimes through a blood vessel in your neck.
  7. After inserting the catheter into your blood vessel, your doctor will direct it into the interior of your heart. They'll use ultrasound to determine its direction.
  8. Your doctor will use the catheter's tip to zap the troublesome spots in your centre. After  that, the heart's electrical current should be restored and blood should flow normally.
  9. Doctors may use these sources of energy to generate scar tissue:
    • Radiofrequency waves
    • Microwaves
    • Lasers
    • Cryothermy (this freezes tissue)

Radiofrequency Ablation vs. Cryoablation

For decades, radiofrequency ablation has been used. It takes less than a minute for your surgeon to inflict the damage that results in scar tissue with this procedure. However, it is less effective in areas with low blood flow. And its impact may be temporary.

Cryoablation is a more recent technique that uses extremely cold temperatures to freeze problematic areas of the heart. It is reversible, allowing the surgeon to examine an area to see whether it works. If not, they can easily rewarm it without causing any harm. This procedure is slightly more time consuming than radiofrequency ablation.

Your doctor will choose an ablation technique based on the part of your heart that needs to be treated as well as their level of comfort for each procedure.

After Procedure

After your ablation, you may need to stay in the hospital overnight so that your doctor and nurses can monitor your recovery. After the treatment, you'll normally rest for 6 to 8 hours. Some patients are discharged from the hospital the same day. The majority of people return home the next morning.

Your doctor will let you know how well the operation went and how successful it was in treating your AF.

Recovery

After you go home:

  • For a few days, you may feel sore, exhausted, or have pain in your chest.
  • As you heal, you will need to sleep more than normal for a few days.
  • The work done during your procedure can take several weeks to transform into scar tissue. It's possible that you won't have a regular heartbeat until scar tissue develops. Until then, your heart arrhythmia can appear the same or worse.
  • After your ablation, you may need to take blood thinners for three months.
  • You can also be prescribed antacids or anti-inflammatory medications.
  • It may be necessary to repeat the process in order for it to operate. In the days and weeks after your operation, your doctor will monitor your heart rate to see if you'll need it.

Extra Recovery Tips

Avoid lifting, pushing, or pulling heavy objects for approximately a week after your ablation. This includes refraining from tasks such as mowing the lawn.

  • Additionally, avoid strenuous exercise for approximately three weeks following the treatment.
  • Assure that the surgical wounds remain clean and dry during the healing process.
  • You can shower, but for the first five days, avoid using extremely hot water or avoid soaking in a bath. Gently pat the area around your wound dry.
  • Avoid using lotions and creams directly on your wounds.
  • Consult your doctor if you find any signs of infection at your wound sites, such as fever, redness, heat, swelling, discharge or increasing bleeding.

Risks Of Procedure

Your doctor should inform you of the risks. However, common risks include the following:

  • Bleeding, infection, or discomfort at the site of your catheter insertion
  • Blood clots
  • Accidental injury to the surrounding tissues and organs
  • Accidental injury to the heart

Benefits and Success of Procedure

For the majority of people, catheter ablation permanently eliminates heart arrhythmias such as AF, atrial flutter, and supraventricular tachycardia (SVT). However, it can reappear within a few years, especially if you're:

  • Older
  • Have another heart condition
  • Have high blood pressure
  • Have a history of hard-to-treat AF

If you ever experience a recurrence of AF, your doctor might be able to treat it with medicine. Alternatively, you can need a second procedure. If your symptoms persist, your doctor can recommend implanting a pacemaker to regulate your heart's electrical signals.

Costs

No two hospitals will bill similarly and no two people or AF cases are identical. If your doctor recommends catheter ablation to treat your heart arrhythmia, contact your insurance provider to confirm coverage before scheduling the operation.

Sources

Referenced on 13/4/2021

  1. Cleveland Clinic: “Surgical Procedures for Atrial Fibrillation (MAZE).”
  2. University of Southern California Keck School of Medicine: “A Patient's Guide to Heart Surgery,” “Robotic-Assisted MAZE Surgery.”
  3. Society of Thoracic Surgeons: “Atrial Fibrillation Surgery — Maze Procedure.”
  4. Cedars-Sinai Hospital: “Preparing for Maze Surgery.”
  5. American Heart Association: “Treatment Guidelines of Atrial Fibrillation (AF or AF).”
  6. Piedmont Healthcare: “Catheter ablation: Radiofrequency vs. cryoablation."
  7. Mayo Clinic: “Pulmonary vein isolation."
  8. https://www.webmd.com/heart-disease/atrial-fibrillation/catheter-ablation-AF-atrial-fibrillation

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