What To Expect During Catheter Ablation

Catheter ablation is done in a hospital. Doctors who do this procedure have special training in cardiac electrophysiology (the electrical system of the heart) and ablation (destruction) of diseased heart tissue.

At the Start

Before the procedure, you're given medicine through an intravenous (IV) line inserted in a vein in your arm. The medicine will help you relax. It may make you sleepy. You're also connected to several machines that check your heart's activity during the procedure.

Once you're drowsy, your doctor numbs an area on your arm, groin (upper thigh), or neck. A needle is used to make a small hole through the skin into a blood vessel. Your doctor puts a tapered tube called a sheath through this hole.

Your doctor then puts a thin, flexible wire and an ablation catheter (a long, thin, flexible tube) through the sheath and into your blood vessel. The guide wire is threaded through your blood vessel to your heart. The wire helps your doctor place the catheter correctly.

Then, your doctor puts a special dye into the catheter. The dye makes the inside of your heart show up on special x-ray images called angiograms. The images help your doctor place the tip of the catheter in the correct spot in the heart.

During the Procedure

Electrodes at the end of the catheter are used to stimulate the heart and record its electrical activity. This helps your doctor learn where abnormal heartbeats are starting in your heart.

Your doctor aims the tip of the catheter at the small area of heart tissue where the abnormal heartbeats are starting. A special machine sends energy through the catheter to create a scar line, also called an ablation line. The types of energy used include radiofrequency (heat generated by electrodes), laser, or cryo- (very cold temperatures).

The scar line creates a barrier between the damaged heart tissue and the surrounding healthy heart tissue. This stops abnormal electrical signals from traveling to the rest of the heart and causing arrhythmias.

The animation below shows catheter ablation. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.

The animation shows an ablation catheter inserted into the heart. This catheter is used to destroy, or ablate, a small part of the heart muscle that's causing arrhythmias. The process allows the heart to return to its normal rhythm.

What You May Feel

You may sleep on and off during the procedure. You generally will not feel anything except for:

• A burning sensation when the doctor injects medicine into the area where the catheter will be inserted
• Discomfort or burning in your chest when the energy is applied
• A faster heartbeat during studies of your heart's electrical system

The procedure lasts 3 to 6 hours. When the procedure is done, your doctor will pull back the ablation catheter and take it out along with the sheath and guide wire.

The opening left in the blood vessel is closed and bandaged. Nurses apply pressure to this site to help prevent major bleeding and to help the site begin to heal.