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.