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What is Cardiac Catheter Ablation for Cardiac Arrhythmias?
What is an Arrhythmia?
Normally, the heart’s impulses travel down an electrical pathway through the heart. The atria or top two chambers of your heart and the ventricles, the bottom two chambers of your heart, work together to pump blood through the heart. The electrical system of the heart is the power source that makes this possible. Each electrical impulse causes the heart to beat.
Arrhythmias are heart rhythm problems — they occur when the electrical impulses in your heart don’t work properly, causing your heart to beat too fast, too slow or irregularly.
Arrhythmias are often harmless. Most people have occasional, irregular heartbeats that may feel like a fluttering or a skipped beat. However, some arrhythmias may cause bothersome and sometimes even life-threatening signs and symptoms.
Your doctor will assess your symptoms and attempt, in many cases, to capture the arrhythmia with some type of EKG monitoring. In some instances, certain types of arrhythmias can be treated effectively with medications. Though, if you have persistent symptoms while taking medications, the medications cause side effects, you don’t want to take the medications long term or have an unclear diagnosis after an extensive work-up, your doctor may recommend an electrophysiology study and possible catheter ablation.
What is catheter ablation?
During an ablation, a doctor inserts 3 or 4 catheters which are thin, flexible wires into the heart through the groin or neck. A special machine delivers energy through the catheter to "mark" a small area of the heart muscle that causes the abnormal heart rhythm. This energy gets rid of the pathway of the abnormal rhythm and resets your heart back to normal. The type of ablation performed depends upon the type of arrhythmia and usually takes 2 to 4 hours to complete.
What types of rhythms are treated with this procedure?
AV Nodal Reentrant Tachycardia (AVNRT):An extra pathway lies in or near the AV node, which causes the impulses to move in a circle and re-enter areas it already passed through.
Accessory Pathway (Wolf-Parkinson-White Syndrome):Extra pathways can exist from birth that connects the atrium and ventricles. The extra pathway causes signals to travel back to the atrium, making it suddenly beat faster.
Atrial Tachycardias (also known as ectopic atrial tachycardias): Caused by a specific focus of cells in the atria that beat intermittently and rapidly. These rhythms tend to be brief (lasting seconds or minutes) and intermittent, but can be a cause of sustained rapid heart rhythms in some people.
Atrial Fibrillation and Atrial Flutter: Extra signals originating in different parts of the atrium cause the atria to beat rapidly (atrial flutter) or quiver (atrial fibrillation).
Ventricular Tachycardia: A rapid, potentially life-threatening rhythm originating from impulses in the ventricles. The rapid rate prevents the heart from filling with enough blood and may severely drop blood pressure. Some of these arrhythmias are amenable to ablation techniques.
Are there any risks?
The catheter ablation procedure is generally very safe. However, as with any invasive procedure, there are risks. Some possible complications are bleeding, infection, and pain where the catheter was inserted. Your doctor will discuss the risks of the procedure with you.
How do you prepare before the procedure?
Should I take my medications? Prior to the procedure, your doctor will discuss what medications to continue taking or what medications to stop.
Can I eat before the procedure? You will not be able to eat or drink anything after midnight before your procedure. If you must take medications, you will be instructed to take them with a very small sip of water. When brushing your teeth, do not swallow any water.
Where does the procedure take place? You will be instructed on what time to arrive and where to arrive the day of your procedure. You can call the office at (408) 839-5900 if you have any questions.
What to expect after the procedure
After the procedure, you will be moved to a recovery area where you will need to lie still for 4 to 6 hours to prevent bleeding from the catheter insertion sites. Some people are able to go home the same day. Others need to stay overnight depending on what type of catheter ablation was performed.
Recovery is usually quick. Most people return to normal activity in a few days. Talk to your doctor about signs and symptoms to watch for. Let your doctor know if you have a large amount of bleeding at the catheter insertion site or pain, swelling, redness, or other signs of infection.
You will be given specific recommendations in regard to your discharge care including activity and when you may return to work.
Although catheter ablation can be successful, some people need repeat procedures. You may also need to take medications, even after you’ve had an ablation. It is important that you continue your medications as instructed, make dietary changes as necessary, live a healthy lifestyle and keep your follow up appointments. We want you to be an active member of your treatment team.