This nonsurgical procedure is used to treat some types of rapid heart beating, such as atrial fibrillation, atrial flutter and atrial tachycardia. It's most often used to treat supraventricular tachyarrhythmias. These are rapid, uncoordinated heartbeats starting in the heart's upper chambers (atria) or middle region (AV node or the very beginning portion of the heart's electrical system).
How is Radiofrequency Ablation Done?
A physician guides a catheter with an electrode at its tip to the area of heart muscle where the damaged site is located. Then a mild, painless radiofrequency energy (similar to microwave heat) is transmitted to the site of the pathway. Heart muscle cells in a very small area (about 1/5 of an inch) die and stop conducting the extra impulses that caused the rapid heartbeats.
How Effective and Safe is this Procedure?
Radiofrequency ablation has a success rate of over 90 percent, a low risk of complications and the patient can resume normal activities in a few days. It causes little or no discomfort and is done under mild sedation with local anesthesia. For these reasons, it's now widely used and is the preferred treatment for many types of rapid heartbeats.
Radiofrequency ablation that is done through a catheter to the targeted site is a transcatheter approach. Newer advances now permit therapeutic ablations using a transcatheter approach. In this technique, an electrode catheter inserted through a blood vessel during electrophysiologic studies is used to perform targeted electrocautery in the heart. A patient may be cured of tachycardia through ablative therapy, so antiarrhythmic medication is no longer needed. Transcatheter ablation is rapidly becoming the treatment of choice for many supraventricular tachycardias.
What is Catheter Ablation? Catheter ablation is a procedure that uses radiofrequency energy (similar to microwave heat) to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. Destroying this tissue helps restore your heart’s regular rhythm. The procedure is also called radiofrequency ablation.
- Catheter ablation is used to treat abnormal heart rhythms (arrhythmias) when medicines are not effective or for side effects.
- Medicines help to control the abnormal heart tissue that causes arrhythmias. Catheter ablation destroys the tissue.
- Catheter ablation is a low-risk procedure that is successful in about 90 percent of the people who have it.
- This procedure takes place in a special hospital room called an electrophysiology (EP) lab or a cardiac catheterization (cath) lab. It takes 2 to 4 hours.
What Happens During Catheter Ablation?
- A doctor with special training performs the procedure along with a team of nurses and technicians. The procedure is done in a hospital EP or cath lab.
- A nurse will put an IV (intravenous line) into a vein in your arm so you can get medicine (anesthesia) to prevent pain. You may also get a medicine (sedative) to help you relax but you will be awake throughout the procedure.
- The nurse will clean and shave the area where the doctor will be working. This is usually in your groin.
- The nurse will give you a shot — a local anesthetic — to numb the needle puncture site.
- The doctor will make a needle puncture through your skin and into the blood vessel (typically a vein, but sometimes an artery) in your groin. A small straw-sized tube (called a sheath) will be inserted into the blood vessel. The doctor will gently guide a catheter (a long, thin tube) into your vessel through the sheath. A video screen will show the position of the catheter. You may feel some pressure in your groin, but you shouldn’t feel any pain.
- The doctor inserts several long, thin tubes with wires, called electrode catheters, through the sheath and feeds these tubes into your heart.
- To locate the abnormal tissue causing arrhythmia, the doctor sends a small electrical impulse through the electrode catheter. This activates the abnormal tissue that is causing your arrhythmia. Other catheters record the heart’s electrical signals to locate the abnormal sites.
- The doctor places the catheter at the exact site inside your heart where the abnormal cells are. Then, a mild, painless, radiofrequency energy (similar to microwave heat) is sent to the tissue. This destroys heart muscle cells in a very small area (about 1/5 of an inch) that are responsible for the extra impulses that caused your rapid heartbeats.
- Catheter ablation usually takes 2 to 4 hours. If you have more than one area of abnormal tissue, the procedure will take longer. You can usually go home the same day, or you may have to stay overnight.
NOTE: During this procedure, the tip of a catheter is guided to the area of heart tissue that is producing abnormal electrical signals. Then the catheter emits a pulse of painless radiofrequency energy that destroys the abnormal tissue and corrects the irregular heartbeat.