Catheter Ablation: Basic Knowledge

Special cells in the heart create electrical signals that travel along pathways to the heart chambers. These signals make the heart’s upper and lower chambers beat in the proper sequence and rhythm. Abnormal tissue may create disorganized electrical signals causing rapid or irregular heartbeats called arrhythmias. During a catheter ablation, the cardiologist uses electrodes to deliver a safe pulse of radiofrequency energy to destroy these diseased areas of heart tissue. This helps to restore the heart’s regular rhythm.  

In case your physician has recommended catheter ablation to you, you will receive detailed instructions about how to prepare for the surgery. Your interventional cardiologist may advise the following among other things: 

• To stop taking blood-thinning medication several days before surgery. 

• To stop eating for about 12 hours prior to procedure  

• If you take other medication regularly, ask your physician if you should continue taking the medication before your procedure. 

Catheter ablations take place in a special room known as an electrophysiology laboratory, sometimes called a cath lab. The procedure usually takes two to four hours. Depending on the arrhythmia being treated, the procedure may take place under general or local anesthesia with sedation. 

To reach the affected area, the physician will introduce a thin flexible tube, the introducer sheath, into a large blood vessel in the patient’s groin. The cardiologist then inserts several catheters through the sheath and gently guides them into the correct position in your heart. To locate the abnormal tissue causing the arrhythmia, the cardiologist sends a small electrical impulse through the electrode catheter. This activates the abnormal tissue, making it visible. Then the doctor will use mild radiofrequency heat energy to destroy or “ablate” the problem area which is usually very small.  

Other types of ablation techniques may be used, such a cryoablation, in which very cold temperatures destroy the problem area. The resulting scarification isolates the affected area from the healthy area of the heart, restoring a normal heart rhythm.  

You will probably need to lie still for a while after the procedure to decrease the risk of bleeding. Some people can leave the hospital the same day of the ablation. Others will stay in the hospital for one or more nights.  

In the days after the procedure, you may have a mild chest ache or bruising in the area where the catheter was inserted. Most people can resume their normal activities within a few days. Be sure that you follow the instructions that your healthcare team has given you, especially regarding follow-up visits and medication. If you notice unusual swelling or pain, bleeding, or consistent irregularities in your heartbeat, contact your doctor immediately.