Catheter ablation is a procedure used to selectively destroy areas of the heart that are causing a heart rhythm problem.
Thin, flexible wires called catheters are inserted into a vein, typically in the groin or neck. They are threaded up through the vein and into the heart. There is an electrode at the tip of each wire. The electrode sends out radio waves that create heat. This heat destroys the heart tissue that causes the fast heart rate. Another option is to use freezing cold to destroy the heart tissue.
Catheter ablation is done in a hospital where the person can be carefully monitored. The procedure is done with an electrophysiology (EP) study, which can identify specific areas of heart tissue where the fast heart rate may start or where abnormal electrical pathways are located inside or outside the atrioventricular (AV) node. This allows doctors to pinpoint exactly what tiny area of heart muscle to destroy.
A local anesthetic is used at the site where the catheter is inserted. The person usually stays awake during the procedure but may be sedated.
What To Expect
Recovery from catheter ablation is usually quick. Some people may be hospitalized for 1 to 2 days after the procedure so doctors can monitor heart rate and rhythm. Many people go home the same day.
Why It Is Done
Catheter ablation is often used for people who have persistent or recurrent fast heart rates that do not respond to drug therapy. Or it is used for people who have certain types of fast heart rates and who do not want to take medicine.
Ablation might be done to treat:
How Well It Works
Catheter ablation can eliminate atrioventricular nodal reciprocating tachycardia (AVNRT), a type of supraventricular tachycardia, in almost all cases.footnote 1
This procedure can successfully eliminate WPW most of the time. There is a small risk of the arrhythmia recurring even after successful ablation of WPW. But a second session of catheter ablation is usually successful.footnote 1
For ventricular tachycardia, catheter ablation might make the arrhythmia happen less often or stop the arrhythmia from happening again.
Catheter ablation is considered safe.
But it has some risks. They include:footnote 3
- Cardiac tamponade.
- Heart attack.
- Heart valve damage.
- Pneumothorax (collapsed lung).
You will have to decide whether the possible benefits of ablation outweigh these risks. Your doctor can help you decide.
If there is damage to the heart's electrical system during the procedure, you will need a pacemaker. This may happen in about 1 out of 100 people.footnote 3 This means that 99 out of 100 people may not need a pacemaker. With some types of SVT, where the abnormal cells are not close to the heart's electrical system, there is a lower risk of needing a pacemaker.
What To Think About
For help on the decision to have catheter ablation, see:
- Page RL, et al. (2015). 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. DOI: 10.1161/CIR.0000000000000311. Accessed September 23, 2015.
- Al-Khatib SM, et al. (2017). 2017 AHA/ACC/HRS guideline for management of patients with ventricular tachycardias and the prevention of sudden cardiac death. Circulation, published online October 30, 2017. DOI: 10.1161/CIR.0000000000000549. Accessed November 6, 2017.
- Calkins H, et al. (1999). Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. The Atakr Multicenter Investigators Group. Circulation, 99(2): 262–270. DOI:10.1161/01.CIR.99.2.262. Accessed January 19, 2016.
Current as of: December 16, 2019