Heart ablation, also called cardiac ablation, is a minimally invasive procedure used to treat certain heart rhythm disorders. These disorders, called arrhythmias, happen when abnormal electrical signals cause the heart to beat too quickly, irregularly or in an unsafe pattern.
During ablation, a cardiac electrophysiologist guides thin, flexible tubes called catheters through blood vessels and into the heart. The physician maps the heart’s electrical activity and treats small areas of tissue that are causing or carrying abnormal signals.
Depending on the condition, ablation may eliminate the abnormal rhythm, make it happen less often or improve symptoms such as palpitations, dizziness, fainting, shortness of breath, chest discomfort and fatigue.
Heart ablation may be used to treat:
The type of arrhythmia, where it begins and how it affects your health will help determine whether ablation may be appropriate.
Learn more about heart rhythm disorders.
Ablation is not needed for every heart rhythm disorder. Your care team may recommend it when:
For some arrhythmias, ablation may be considered early in treatment. For others, your care team may recommend medication or another approach first.
Your electrophysiologist will choose an ablation approach based on your specific condition rather than simply selecting the newest technology.
The physician may consider:
Some ablations are more complex because the abnormal signals are difficult to locate, begin in several areas or occur near sensitive heart structures. Ventricular arrhythmias, structural heart disease and rhythms that return after a previous procedure may also require more advanced mapping or navigation.
Your electrophysiologist may use heat, cold or electrical pulses to treat the targeted heart tissue. The right energy source depends on the arrhythmia, the location being treated and other details of your condition.
Radiofrequency ablation uses controlled heat to treat small areas of heart tissue involved in the abnormal rhythm.
It can be used for several types of arrhythmias, including SVT, atrial flutter, atrial fibrillation and certain ventricular arrhythmias.
Cryoablation uses cold energy to freeze targeted heart tissue and block abnormal electrical signals.
It may be used for certain arrhythmias based on where the abnormal signals begin and the treatment approach your physician recommends.
Pulsed field ablation, or PFA, uses short electrical pulses rather than heat or cold to treat targeted heart tissue.
PFA is most commonly used for certain patients with atrial fibrillation. Its effects are designed to focus on heart muscle cells while limiting the effect on some nearby tissues.
Your electrophysiologist will determine whether PFA or another energy source is the best choice based on your heart rhythm disorder, anatomy and treatment history.
Before delivering ablation energy, the electrophysiologist maps the electrical signals inside your heart.
Catheters record electrical activity from several locations. Computer technology then creates a detailed three-dimensional map showing how the signals travel and where the arrhythmia may begin.
Advanced mapping helps the physician:
The physician may attempt to trigger the arrhythmia in a controlled setting before or after treatment. This helps confirm the source of the rhythm and whether the treated pathway can still carry abnormal signals.
Stereotaxis Genesis is a robotic magnetic navigation system. It is not a separate form of ablation or energy. It helps the electrophysiologist guide a specially designed catheter through the heart.
Magnets positioned outside the body create a magnetic field that controls the direction of the catheter. The physician operates the system from a workstation and uses detailed imaging and electrical mapping to guide the catheter to targeted areas.
Robotic magnetic navigation may be considered for certain procedures when precise catheter movement or access to a difficult location could be helpful. It may be used in some complex arrhythmias, including certain ventricular rhythms or arrhythmias that have returned after previous treatment.
The technology used depends on your condition, anatomy and physician’s assessment. Not every ablation requires robotic magnetic navigation.
Before the procedure, your care team will:
You may need tests such as:
Follow your care team’s instructions carefully. Do not stop a heart medicine or blood thinner unless your provider tells you to do so.
You will need to arrange transportation home after the procedure.
You may receive sedation or general anesthesia, depending on the type and expected length of the procedure.
The electrophysiologist will:
The physician may need to map and treat more than one area. Procedures can vary considerably in length based on the type and complexity of the arrhythmia.
Your care team will monitor your heart rhythm, blood pressure, breathing and other vital signs throughout the procedure.
After the procedure, you will be monitored in a recovery area. You may need to lie flat for several hours to reduce bleeding from the catheter insertion site.
Some patients go home the same day. Others stay in the hospital overnight or longer depending on the procedure and their overall health.
Your care team will explain:
Temporary soreness, fatigue, mild chest discomfort or palpitations can occur during recovery. Your care team will explain what is expected and when symptoms should be evaluated.
The heart needs time to heal after ablation. Some people have palpitations or brief rhythm changes during the healing period. These symptoms do not always mean the procedure was unsuccessful.
Follow-up may include:
Some arrhythmias can return after ablation. If that happens, your electrophysiologist may recommend medication, additional monitoring or another ablation procedure.
A repeat procedure may target a pathway that recovered, an area that was not apparent during the first procedure or a new source of abnormal signals. Your physician may also consider a different mapping, energy or catheter-navigation approach.
Heart ablation is generally considered safe, but all procedures have risks. These may vary based on the arrhythmia, the area treated and your overall health.
Possible risks include:
Your electrophysiologist will explain the risks that apply to your planned procedure.
Seek medical care right away for serious or worsening symptoms after ablation, including severe chest pain, difficulty breathing, fainting, uncontrolled bleeding or increasing pain, swelling or redness at the insertion site.
The decision to have heart ablation depends on the type of arrhythmia, your symptoms, the risks associated with the rhythm and how you have responded to other treatments.
A cardiac electrophysiologist can explain:
Banner Health cardiac electrophysiologists use advanced mapping, ablation and catheter-navigation technologies to treat common and complex heart rhythm disorders.
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