In catheter ablation, a form of energy renders a small section of problem causing tissue inactive.
This puts an end to arrhythmias that originated at the problematic site. Normally, electricity flows throughout the heart in a regular, measured pattern. This normally operating electrical system is the basis for coordinated heart muscle contractions.
Sometimes, the electrical flow gets blocked or travels the same pathways repeatedly creating something of an electrical “short circuit” that disturbs normal heart rhythm. Medicine often helps. In some cases, however, the most effective treatment is to destroy the heart tissue housing the short circuit. This procedure is called catheter ablation. Catheter ablation is just one of a number of terms used to describe the non-surgical procedure. Other common terms are: cardiac ablation, radiofrequency ablation, or simply, ablation.
The ablation process:
Like many cardiac procedures, ablation no longer requires a full-frontal chest opening (sternotomy). Rather, ablation is a relatively noninvasive procedure that involves inserting catheters – narrow, flexible wires – into a blood vessel in the groin or neck and advancing the wire into the heart. The journey from entry point to heart muscle is navigated by images created by a fluoroscope, an x-ray-like machine that provides continuous, “live images of the catheters and the body.
Once the catheter reaches the heart, electrodes at the tip of the catheter gather data and a variety of electrical measurements are made. The data pinpoints the location causing the arrhythmia. During this “electrical mapping,” the cardiac arrhythmia specialist, an electrophysiologist, may sedate the patient and induce the very arrhythmias that are the crux of the problem. The events are safe, given the range of experts and resources close at hand, and are necessary to identify the precise location of the problematic tissue.
Once the source of arrhythmia is confirmed, energy is used to destroy that tissue, ending the disturbance of electrical flow through the heart and restoring a healthy heart rhythm. This energy may take the form of radiofrequency energy, which cauterizes or burns the tissue, or intense cold, which freezes, or cryoablates the tissue. Other energy sources are being investigated.
Patients rarely report pain, more often describing what they feel as discomfort. Some watch much of the procedure on monitors and occasionally ask questions. After the procedure, a patient remains still for four to six hours to ensure the vessel punctures seal up properly.
Once mobile again, patients may feel stiff and achy from lying still for hours.