Nonsurgical Catheter Ablation

rhythmic heartbeat is controlled by a smooth, constant flow of electricity through the heart. A short-circuit anywhere along this electrical pathway can disrupt the normal flow of signals, causing an arrhythmia (an irregular heartbeat). Cardiac ablation is a procedure used either to destroy these short-circuits and restore normal rhythm, or to block damaged electrical pathways from sending faulty signals to the rest of the heart.

Cardiac ablation is performed by a cardiac electrophysiologist — a physician who specializes in diagnosing and treating heart rhythm disorders. The procedure involves inserting catheters — narrow, flexible tubes — into a blood vessel, often through a site in your groin or neck, and threading them through the vein until they reach your heart. You will be given sedatives to make you relaxed and comfortable, and a topical anesthetic to numb your skin before the catheters are inserted.

Using electrodes on the tip of the catheters, the doctor first conducts an electrophysiology (EP) study to pinpoint the location of the short-circuit. Once the precise location is confirmed, the “short-circuit” is either destroyed (to reopen the electrical pathway) or blocked (to prevent it from sending faulty signals to the rest of the heart). This is done by sending energy through the catheters to destroy a small amount of tissue at the site. The energy may be either hot (radiofrequency energy), which cauterizes the tissue, or extremely cold, which freezes or “cryoablates” it.

Most people say they experience only brief moments of discomfort, rather than pain, during the procedure. As with an EP study, you will need to lie still for four to six hours afterward to make sure your catheter incision starts healing properly.

Results:  Cardiac ablation is an effective treatment for many types of arrhythmias. It is successful in 90 to 98 percent of cases, eliminating the need for open-heart surgery or long-term drug therapy.

Ablation therapy using radio frequency waves on the heart is used to cure a variety of cardiac arrhythmia such as supraventricular tachycardia (SVT), Wolff–Parkinson–White syndrome (WPW), ventricular tachycardia, and more recently as management of atrial fibrillation. The term is often used in the context of laser ablation, a process in which a laser dissolves a material's molecular bonds. For a laser to ablate tissues, the power density or fluence must be high, otherwise thermocoagulation occurs, which is simply thermal vaporization of the tissues.

Non-surgical ablation, used for many types of arrhythmias, is performed in a special lab called the electrophysiology (EP) laboratory. During this non-surgical procedure a catheter is inserted into a specific area of the heart. A special machine directs energy through the catheter to small areas of the heart muscle that causes the abnormal heart rhythm. This energy "disconnects" the source of the abnormal rhythm from the rest of the heart. It can also be used to disconnect the electrical pathway between the upper chambers (atria) and the lower chambers (ventricles) of the heart.