What is a Cardiac Ablation?
Cardiac ablation is a treatment performed by an interventional cardiologist who specialises in conducting treatments for heart attacks. This procedure involves threading catheters through a blood vessel and into the heart. To treat an irregular heartbeat, the cardiologist uses electrodes to administer a secure electric pulse to areas of your heart.
Cardiac ablation works by destroying the tissue in the heart which triggers or sustains an abnormal heart rhythm. In certain cases, cardiac ablation prevents the heart from receiving irregular electrical signals and thereby avoids arrhythmia. Typically, cardiac ablation uses long, flexible tubes (catheters) inserted into your groin through a vein or artery and threaded to your heart to transmit energy in the form of heat or intense cold to change the tissues that cause arrhythmias in the heart. Cardiac ablation is often performed by open-heart surgery, but catheters are also used to make the operation less invasive.
Why is Cardiac ablation done?
Sometimes your heart beats very fast or slow. These issues with heart rhythm are referred to as arrhythmias and can often be treated by cardiac ablation. Arrhythmias are very common, particularly in older adults and people who have heart diseases. Many people who are living with arrhythmias don’t have any serious symptoms or need any kind of medical attention. But some people can need serious medical care.
People who can see improvement from cardiac ablation include, who:
- Are having arrhythmias and don’t respond to any kind of medications
- Suffer from some serious side effects from arrhythmias medications
- Are having some specific kind of arrhythmias that tend to respond well to cardiac ablation
- Are at a high risk of sudden cardiac arrest or some other complications
- Cardiac ablation can be helpful for people with some specific kind of arrhythmias:
- AV nodal re-entrant tachycardia (AVNRT): a very rapid pulse resulting from a short heart circuit.
- Accessory pathway: a rapid heartbeat because of an irregular electrical path linking the upper and lower chambers of the heart.
- Atrial fibrillation and atrial flutter: an irregular and rapid pulse beginning in the upper two chambers of the heart.
- Ventricular tachycardia: a very rapid and dangerous rhythm beginning in the two lower chambers of the heart.
Risks of Cardiac Ablation
The risks of blood clots, heart disease, or stroke go up if you don't treat Atrial fibrillation. There may be life-threatening ones. Before they prescribe a prescription, the doctor will take the risk factors into consideration. If you do not have any symptoms, even if they are mild, you might have a doctor monitoring you and waiting. But in order to protect you from strokes, they might prescribe warfarin or another blood thinner. Cardiac ablation is right for you if you are having Atrial fibrillation symptoms that are very severe and make it very hard for performing daily tasks.
Cardiac Ablation Procedure
Before the Cardiac Ablation Procedure
- You will be examined by the doctor and you would be asked for multiple tests to determine your heart condition. The physician will discuss the complications and benefits of cardiac ablation with you.
- The night before your operation, you will be asked to stop eating and drinking. If you are taking some medical drugs, ask your doctor if you can continue to take them prior to the operation.
- Your doctor will let you know whether, before or after your treatment, you need to follow any other special instructions. In certain cases, a few days before the operation, you will be told to avoid taking medicine to treat cardiac arrhythmias.
- If you have an implanted heart device such as a pacemaker or an implantable cardioverter-defibrillator, speak to the doctor to see if you need to take any special measures.
During the Cardiac Ablation procedure
- Firstly, the doctor will implant an intravenous line into your forearm or hand before your treatment starts, and you'll be given a sedative for relaxing. General anaesthesia can be used in certain cases to put you in a sleep state. Depending on the situation anaesthesia is given to you.
- The doctor will numb your groin, neck or forearm in a small area near a vein until your sedative takes effect. In the vein, the doctor sticks a needle and puts a tube (sheath) through the needle.
- Through the sheath, your doctor will thread catheters and direct them to many locations within your heart. Using X-ray imaging, your doctor can inject dye into the catheter that lets the doctor see your blood vessels and heart. The catheters have electrodes at the tips that can be used to give the heart electrical impulses and record the electrical activity of your heart.
- This method of using imaging and other measures is called an electrophysiology (EP) analysis to determine what causes your arrhythmia. In order to assess the most efficient way to treat your arrhythmia, an EP analysis is typically performed prior to cardiac ablation.
- When the abnormal heart tissue which causes the arrhythmia is identified, the doctor will aim the catheter tips at the area of abnormal heart tissue. In order to create a scar or remove the tissue that causes the arrhythmia, energy can pass through the catheter tips.
- Ablation in some cases blocks the electrical signals that pass through your heart to avoid the erratic rhythm and instead allow signals to travel through a normal pathway.
- The energy used in the procedure comes from:
- -Extreme cold (cryoablation)
- -Heat (Radiofrequency)
- It normally takes three to six hours for cardiac ablation to complete, but complex procedures can take longer. It is likely that you will experience some slight pain during the operation when the catheter is moved in your heart and when energy is given. Let your doctor know if you experience some form of extreme pain or shortness of breath.
After the Cardiac Ablation Procedure
- You will be moved to a recovery area after your procedure to rest peacefully for 4 to 6 hours to stop bleeding at the catheter site. To check for complications of the operation, your pulse and blood pressure will be monitored continuously.
- You might be able to go home on the same day as your treatment, depending on your condition, or you may need to stay in the hospital.
- After your treatment, you can feel a little sore, but the soreness shouldn't last longer than a week. Usually, after getting cardiac ablation, you will be able to return to your normal activities within a few days.
Cardiac Ablation Recovery
Atrial fibrillation cannot be healed by catheter ablation, but it will also relieve the symptoms. During the first 3 months, you will still have Atrial fibrillation episodes because it takes so long for the scars to form. If you have had Atrial fibrillation for a long time, you may need another medication to keep your pulse going on a regular basis. You will still need medication for a few months after the operation to regulate the heart rhythm.
Long-term relief from their symptoms is obtained by most people who have the maze treatment. And afterwards, many may not need to take heart rhythm medication. To keep your heart safe, your doctor can prescribe lifestyle changes, including:
- Eat a healthy diet with less salt and alcohol
- Quit smoking
- Keep a healthy weight according to your height
- Get into more physical activity
- Manage your stress