Catheter ablation is done in a hospital. Doctors who do this procedure have special training in cardiac electrophysiology (the heart's electrical system) and ablation (destruction) of diseased heart tissue.
Before the Procedure
If you're a woman of childbearing age, your doctor might recommend a pregnancy test before catheter ablation to make sure you're not pregnant. The procedure involves radiation, which can harm the fetus. If you're pregnant, talk with your doctor about whether the benefits of the procedure outweigh the risks.
Before the procedure, you'll be given medicine through an intravenous (IV) line inserted into a vein in your arm. The medicine will help you relax and might make you sleepy. You'll also be connected to several machines that will check your heart's activity during the procedure.
Once you're drowsy, your doctor will numb an area on your arm, groin (upper thigh), or neck. He or she will use a needle to make a small hole in one of your blood vessels. Your doctor will put a tapered tube called a sheath through this hole.
Next, your doctor will put a series of catheters (thin, flexible wires) through the sheath and into your blood vessel. He or she will thread the wires to the correct place in your heart.
An imaging method called fluoroscopy (flor-OS-ko-pe) will help your doctor see the wires as they're moved into your heart. Fluoroscopy uses real-time x-ray images.
During the Procedure
Electrodes at the end of the catheters will stimulate your heart and record its electrical activity. This will help your doctor learn where abnormal heartbeats are starting in your heart.
After your doctor pinpoints the source of the abnormal heartbeats, he or she will aim the tip of a special catheter at the small area of heart tissue. A machine will send energy through the catheter to create a scar line, also called an ablation line.
The scar line will create a barrier between the damaged heart tissue and the surrounding healthy heart tissue. This will stop abnormal electrical signals from traveling to the rest of the heart and causing arrhythmias.
The animation below shows the process of 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.
What You Might Feel
You might sleep on and off during the procedure. You generally will not feel anything except for:
- A burning sensation when your doctor injects medicine into the area where he or she will insert the catheters
- Discomfort or burning in your chest when your doctor applies the energy
- A faster heartbeat when your doctor stimulates your heart to find out where abnormal heartbeats are starting
The procedure lasts 3–6 hours. When it's over, your doctor will remove the catheters and the sheath. He or she will close the opening in your blood vessel and bandage it. Pressure will be applied to the site to help prevent major bleeding.