How is ablation of the heart done




















Catheter ablation: Technical aspects. Atrial fibrillation: Catheter ablation. Bonow RO, et al. Atrial fibrillation: Clinical features, mechanisms, and management. Wang R, et al. Sudden death and its risk factors after atrioventricular junction ablation and pacemaker implantation in patients with atrial fibrillation.

Clinical Cardiology. Calkins H, et al. Lee R. Surgical ablation to prevent recurrent atrial fibrillation. Mulpuru SK expert opinion. Mayo Clinic. Noseworthy PA, et al. European Society of Cardiology. Al-Hijji MA, et al. Trends and predictors of repeat catheter ablation for atrial fibrillation. American Heart Journal. Brown AY. Allscripts EPSi. Packer DL, et al. Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation.

Quick facts Catheter ablation is used to treat abnormal heart rhythms arrhythmias when medicines are not tolerated or effective. Medicines help to control the abnormal heart tissue that causes arrhythmias. Catheter ablation destroys the tissue. Catheter ablation is a low-risk procedure that is successful in most people who have it. This procedure takes place in a special hospital room called an electrophysiology EP lab or a cardiac catheterization cath lab.

It takes 2 to 4 hours. Why do people have catheter ablation? What are the risks of catheter ablation? How should I prepare for catheter ablation? Your doctor will tell you what to eat and drink during the 24 hours before the test.

Tell your doctor about any medicines you take. He or she may ask you not to take them before your test. Leave all your jewelry at home. Arrange for someone to drive you home after your procedure.

What happens during catheter ablation? A nurse will put an IV intravenous line into a vein in your arm so you can get medicine anesthesia to prevent pain. You may also get a medicine sedative to help you relax but you will be awake throughout the procedure. The nurse will clean and shave the area where the doctor will be working. This is usually in your groin.

The nurse will give you a shot — a local anesthetic — to numb the needle puncture site. The doctor will make a needle puncture through your skin and into the blood vessel typically a vein, but sometimes an artery in your groin.

A small straw-sized tube called a sheath will be inserted into the blood vessel. The doctor will gently guide a catheter a long, thin tube into your vessel through the sheath. Then, the doctor will place three or four catheters through blood vessels to your heart to help guide the procedure. After the catheters have been placed, electrodes at the ends of the catheters are used to stimulate your heart and locate the area that is causing the abnormal heart rhythm. Other types of ablation techniques may be used, such as cryoablation, in which very cold temperatures destroy the problem area.

Your doctor will decide which type of ablation therapy is most appropriate for you. Once the tissue is destroyed, the abnormal electrical signals that created the arrhythmia can no longer be sent to the rest of the heart. Most people do not feel pain during the procedure. You may sense mild discomfort in your chest. After the ablation is over, your doctor will remove the guide wire and catheters from your chest.

After the catheter ablation, you will probably need to lie still for two to six hours to decrease the risk of bleeding. You will need a hour medication treatment before the MRI. Also tell your doctor if you are claustrophobic or if you get anxious in tight spaces. During the MRI, you will be lying on your back.

We will try to make you as comfortable as possible. We will put a cushion under your knees and giving you a ball that you can squeeze in your hand. The ball will alert the technician, who runs the MRI machine, if you are feeling too uncomfortable or having any problems. The MRI machine itself is loud. We will give you headphones so you can hear the technician who runs the machine. The technician will also use the headphones to give you instructions on how to breathe during certain parts of the scan.

Breath in, breath out, hold. This is also a non-invasive, painless test. Note that even if you have an an implantable pacemaker or defibrillator , we can often still safely perform an MRI at University of Utah Health.

However, the quality of the imaging may be lower than usual. We evaluate this on a case-by-case basis. A transesophageal echocardiogram is a sonogram, and does not involve radiation. This sonogram allows your doctor to record images of your heart from inside your esophagus food pipe. This test looks for blood clots in your heart.

It needs to be done 24—48 hours before your ablation procedure, but may instead be done as part of the ablation itself. If we find a clot in your heart, we will reschedule your ablation procedure.

When you arrive for you TEE, you will change into a hospital gown. We will then take you to the testing room. Once in the room, we will spray your throat with an anesthetic to numb it. We may also give you a mild sedative through an IV in your arm to help you relax.

You could also be given oxygen. Then we will ask you to lay on your side. The doctor will gently insert a probe into your mouth. As you swallow, your doctor will slowly guide the tube into your esophagus.

We lubricate the tube is so that it will slide easily. A nurse will monitor your heart rate, blood pressure, and breathing. The test usually takes 20—40 minutes.



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