By eliminating or scarring tissue that causes abnormal electrical signals, cardiac ablation corrects problems with the rhythm of the heart, known as arrhythmia. Heart arrhythmia can affect blood flow and increase the risk of stroke, heart failure, or sudden cardiac death because it causes the heart to beat too fast, too slow, or irregularly.
Arrhythmia can have various causes, such as:
Heart disease or damage, such as coronary artery disease, heart valve disease, heart attack, or cardiomyopathy
High blood pressure, diabetes, thyroid disorders, or other metabolic conditions
Congenital heart defects or genetic factors
Stress, anxiety, caffeine, alcohol, tobacco, or drug abuse
Medications, supplements, or herbal remedies that affect the heart rate or rhythm
Infections, inflammation, or electrolyte imbalances in the body
Some people with arrhythmia may not experience any symptoms, while others may notice:
Heart palpitations, or a feeling of skipped, extra, or irregular heartbeats
Chest pain, discomfort, or pressure
Dizziness, lightheadedness, or fainting
Shortness of breath, difficulty breathing, or wheezing
Fatigue, weakness, or reduced ability to exercise
Sweating, nausea, or vomiting
Confusion, anxiety, or panic
To diagnose arrhythmia, a doctor may perform a physical examination, ask about the medical history and symptoms, and order some tests, such as:
Electrocardiogram (ECG), which records the electrical activity of the heart
Holter monitor, which is a portable device that records the heart rhythm for 24 to 48 hours
Event monitor, which is a device that records the heart rhythm when triggered by the patient or automatically when an abnormality is detected
Echocardiogram, which uses sound waves to create an image of the heart structure and function
Stress test, which measures the heart response to physical exertion
Blood tests, which check for the levels of certain substances that affect the heart, such as electrolytes, hormones, or enzymes
Chest X-ray, which shows the size and shape of the heart and lungs
Electrophysiology study, which involves inserting catheters into the heart to measure the electrical signals and locate the source of arrhythmia
The treatment of arrhythmia depends on the type, severity, and cause of the condition, as well as the patient’s overall health and preferences. Some of the possible treatment options are:
Medications, such as antiarrhythmics, beta blockers, calcium channel blockers, or anticoagulants, which can help control the heart rate, rhythm, or blood clotting
Cardioversion, which is a procedure that delivers an electric shock to the heart to restore a normal rhythm
Pacemaker, which is a small device that is implanted under the skin and sends electrical impulses to the heart to regulate the heartbeat
Implantable cardioverter-defibrillator (ICD), which is a device that is implanted under the skin and monitors the heart rhythm and delivers an electric shock to the heart if a life-threatening arrhythmia occurs
Cardiac ablation, which is the focus of this blog post
Ablation of the heart causes arrhythmia by creating small scars in the heart tissue that are responsible for causing abnormal electrical signals. By destroying or isolating these areas, the procedure can restore a normal heart rhythm and prevent the recurrence of arrhythmia.
There are two main types of cardiac ablation: catheter ablation and surgical ablation.
In cardiac ablation, catheters are typically used. With this minimally invasive procedure, a thin, flexible tube called a catheter is inserted into a blood vessel, usually in the groin or neck, and guided to the heart using ultrasound or X-ray images. The catheter has electrodes at its tip that can deliver different types of energy, such as radiofrequency, cryo, or laser, to the targeted heart tissue. By creating heat or cold, the energy destroys or scars the tissue, blocking abnormal electrical signals.
Depending on the severity of the arrhythmia, catheter ablation can take several hours to complete. Local anesthesia and sedation are usually used for the procedure, but sometimes general anesthesia may be required. For observation and monitoring, the patient may need to stay in the hospital overnight.
As opposed to catheter ablation, surgical ablation involves making incisions in the chest and accessing the heart directly. In general, it is reserved for patients with other heart conditions requiring surgery, such as bypass or valve replacement, or who have failed catheter ablation. A surgeon can cut, stitch, burn, or freeze the heart tissue to create scars. The scars block the abnormal electrical signals and restore a normal heart rhythm.
A surgical ablation procedure can take several hours, depending on the type and extent of the surgery, and requires a longer hospital stay and recovery time than catheter ablation.
Cardiac ablation is generally considered a safe and effective procedure, but like any medical intervention, it carries some risks and potential complications, such as:
Bleeding, infection, or bruising at the catheter insertion site
Damage to the blood vessels, heart valves, or heart muscle
Perforation or tamponade of the heart or pericardium (the sac that surrounds the heart)
Stroke, heart attack, or pulmonary embolism (blood clot in the lungs)
Damage to the normal electrical system of the heart, which may require a pacemaker or an ICD
Recurrence or worsening of the arrhythmia, or development of a new arrhythmia
Kidney damage or failure due to the contrast dye used for imaging
Allergic reaction to the anesthesia or medications
Death (rare)
In addition to the type of arrhythmia, the type of ablation, the patient's age, health, and medical history, and the skill and experience of the doctor performing the procedure, cardiac ablation may have different risks and complications. Before the procedure, the doctor will explain the benefits and risks of cardiac ablation to the patient and obtain informed consent.
After cardiac ablation, the patient will be moved to a recovery room or an intensive care unit (ICU) for observation and monitoring. Medications can relieve some discomfort, soreness, or pain at the catheter insertion site or in the chest. It is also possible for the patient to experience some mild arrhythmias or palpitations, which usually subside in a few weeks.
Several days or weeks after the procedure, the patient will be advised to rest and avoid strenuous activities. In order to prevent infection, blood clots, or recurrence of arrhythmia, the patient will also need to take antiarrhythmics, anticoagulants, or antibiotics prescribed by the doctor. In addition to regular check-ups, tests, and medication adjustments, the patient will need to visit the doctor regularly.
The patient will also need to make some lifestyle changes to improve the heart health and prevent future arrhythmia, such as:
Eating a balanced, low-salt, low-fat, and high-fiber diet
Exercising regularly, as recommended by the doctor
Quitting smoking and avoiding exposure to secondhand smoke
Limiting or avoiding alcohol, caffeine, and other stimulants
Managing stress and practicing relaxation techniques
Maintaining a healthy weight and blood pressure
Treating and controlling any underlying conditions, such as diabetes, thyroid disorders, or sleep apnea
Following the doctor’s instructions and reporting any symptoms or concerns
The following lifestyle changes can help reduce the risk of developing or worsening arrhythmia, especially if they are caused by congenital or genetic factors:
Eating a heart-healthy diet
Exercising regularly
Quitting smoking
Limiting or avoiding alcohol and caffeine
Managing stress
Maintaining a healthy weight and blood pressure
Treating and controlling any underlying conditions
It is also important for the patient to be aware of the signs and symptoms of arrhythmia and seek medical attention as soon as possible. It is also essential that the patient follows his or her doctor's recommendations and takes medications according to prescription. If the patient has a family history or a personal history of heart disease or arrhythmia, they should also undergo regular arrhythmia screening and testing.
Arrhythmias can be treated with cardiac ablation by creating scars in the heart tissue that block the abnormal electrical signals that cause the irregular heartbeat. In addition to the type and severity of the arrhythmia, the patient's overall health and preferences can determine if cardiac ablation should be performed by catheter or surgery. In general, cardiac ablation is safe and effective, but there are some risks and complications involved. To prevent future arrhythmias after cardiac ablation, a period of recovery and follow-up are required, as well as some lifestyle changes.
