Having Catheter Ablation

A heart rhythm problem (arrhythmia) can make your heart beat too fast or in an irregular pattern. The problem is often caused by cells in your heart that are not working as they should. It may also be the result of an abnormal electric pathway in your heart. It may cause bothersome symptoms such as an irregular heartbeat, dizziness, shortness of breath, chest pain or fainting.

Your doctor has recommended catheter ablation to treat your arrhythmia. This invasive but non-surgical procedure will stop the cells that are causing the problem. 

Before the procedure

• Before your catheter ablation, you will meet with a specially trained heart doctor (cardiac electrophysiologist) who will perform the procedure. He or she will examine you and tell you what you need to know before the procedure.
• You will likely be told to stop or change your heart rhythm medicines for a period of time before the procedure. Be sure to follow all of your doctor’s instructions. Tell the doctor about all prescription and over-the-counter medicines you take including herbs, supplements, and vitamins.
• If you are allergic to any medicines, tell the doctor.
• Do not eat or drink anything after midnight the night before or about 8 hours before the procedure or as directed by your healthcare provider. 

How catheter ablation is done

Catheter ablation uses thin, flexible wires (electrode catheters) to find and inactivate (ablate) the problem cells that are causing the arrhythmia within your heart.

Here is how the procedure is done:

• To find the problem, an electrophysiology study (EPS) will be performed.
• During this study, the doctor tries to start (induce) your arrhythmia. An electrical map of the heart will be created. This map will show the type of arrhythmia you have and the area in your heart where it is coming from. Using the map as a guide, the doctor will know where to ablate.
• Problem areas will be inactivated using heat or cold therapy. Once the EPS shows where the problem is, the doctor will thread an electrode catheter through a blood vessel to that area in the heart. Ablation energy will be sent through the catheter which will inactivate the problem cells.
• After ablating the problem cells, the doctor will try to restart (reinduce) your arrhythmia. If the rhythm cannot be restarted, the ablation will be considered a success. If the rhythm does start again, more ablation energy may need to be applied to the problem cells.

Your experience during catheter ablation

The catheter ablation will be performed in the Electrophysiology (EP) Lab. The procedure often takes 2 to 4 hours, but can sometimes take longer.

• You will receive medicine to prevent pain and help you relax or sleep during the procedure. A doctor specializing in anesthesia or a Certified Registered Nurse Anesthetist will administer these medications and monitor you closely during the procedure. Any hair in your groin area (left and right) will be removed by a member of the healthcare team.
• An IV (intravenous) line will be inserted in your arm. Medicines and fluids will be given through this IV.
• To help keep the catheter insertion site germ-free (sterile), both of your groins will be cleaned with antibacterial solution and your body will be covered with sterile sheets.
• Only the area where the catheters will be inserted will be exposed.
• The skin in your groin area will be numbed with a local anesthetic. This may be on the right groin, the left groin, or both.
• Your doctor will insert one or multiple IV lines into your femoral vein through a puncture wound in your groin area. The doctor will then put a small straw-sized tube (called a sheath) into your femoral vein. He/she will use this sheath and pulsed x-ray (fluoroscopy) to gently guide catheters (long thin tubes) and wires into the vessels within your heart.
• Electrical signals produced by your heart will be picked up by the special catheters and recorded. This is called cardiac mapping and allows the doctor to locate where the abnormal beats (arrhythmia) are coming from within your heart.
• When the source of your irregular heartbeat is located, the doctor will use a special ablation catheter to apply energy to the area in your heart that is causing the arrhythmia. This energy will produce a scar that will block the electrical impulses that are causing your arrhythmia.
• When the procedure is complete, the doctor will remove the catheters from your heart and the intravenous (IV) lines will be removed from your groin area.
• Pressure will be applied to catheter insertion site to prevent any bleeding. A suture (small stitch) may be applied to the puncture wound and a gauze dressing (bandage) will be applied over the wound to keep the area clean and dry. If a suture was applied, it will be removed from your groin before you go home.

After the procedure

• You will need to lie flat and keep the leg that had the catheters in place straight for at least 4 hours after the procedure in order to prevent bleeding and swelling at the puncture wound site.
• A nurse will check the insertion site and monitor your heart rate, heart rhythm and blood pressure (vital signs) while you are lying flat.
• After the ablation, you may stay overnight in the hospital, or you may go home the same day. This will depend on the results of the procedure as well as the indication for the procedure. 

Home care

Before you leave the hospital, your nurse or doctor will give you written instructions made especially for you about what to do at home.

The following are some general recommendations for care at home:

• You will not be able to drive yourself home because you had medicine to relax you (sedation).
• You will need to make arrangements for a ride. Your healthcare provider may tell you not to drive for 24 hours after the procedure.
• You can take a shower the day after the procedure, but you should not have a bath or immerse your legs in water for at least 1 week.
• You should be able to go back to your normal daily activities in the next 1 to 2 days. These include walking, climbing stairs, and doing household chores.
• Do not lift objects heavier than 10 pounds for at least one week after the procedure.
• Do not do any heavy physical activity for several days after the procedure. This will allow your body to heal.
• Ask your healthcare provider when you can return to work.
• Take your temperature and check your incision for signs of infection every day for a week. Signs of infection include redness, swelling, drainage, or warmth at the puncture wound site. It is normal to have a small bruise or lump where the catheter was inserted.
• Take your medicines exactly as directed. Do not skip doses. You may need to make some changes in your medicines after the procedure. Be sure to go over your medicine instructions with your healthcare provider before you are discharged.
• Learn to take your own pulse. Keep a record of your results. Ask your healthcare provider which readings mean that you need medical attention. 

Follow-up care

• Make a follow-up appointment as directed by your healthcare provider. Your provider will check how your incision site is healing.
• In many cases, one ablation is enough to treat an arrhythmia.
• Sometimes the problem comes back or another is found. If this happens, you may need a second procedure.

© The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. This information has been modified by your health care provider with permission from the publisher.