Not all cardiac arrhythmias respond adequately to treatment with medication. In such instances, cardiac ablation is recommended and performed. During this procedure, specialized catheters are used to selectively eliminate the heart cells responsible for causing the arrhythmias. Radiofrequency electrical energy is delivered through the catheters. The physician cauterizes the heart tissue that is blocking the normal path of electrical signals in the heart. There are complications associated with this invasive procedure.
Bleeding and Infection
The staff of Brigham and Women’s Hospital rank bleeding at the site of catheter insertion and infection as the most common complications associated with ablation.
During the procedure, the groin area or the right side of the neck—the preferred sites for catheter insertion—are shaved and cleansed with an antiseptic solution. The patient is covered from neck to toes with a large sterile drape. The site is anesthetized with a local anesthetic. Once the problem area in the heart is identified, the specially trained physician inserts the catheters through a small incision made in a large blood vessel in the groin or neck.
Damage to Blood Vessels
When the physician inserts the catheter that will deliver the radiofrequency energy, he passes it through blood vessels to reach the problem area. MayoClinic.com warns of possible damage to the blood vessels that can occur if the catheter scrapes the walls as it is passed to the heart.
Formation of a Blood Clot
Brigham and Women’s Medical Center and MayoClinic.com caution patients that the formation of a blood clot can occur as a result of ablation of the heart. A blood clot can lead to a heart attack, stroke or pulmonary embolism. A clot that travels to the brain can block an artery and cause a stroke. A pulmonary embolism, which causes blockage of an artery in the lungs, occurs when a clot travels to the lungs.
Damage to the Heart
Ablation can damage the heart’s electrical system. During cardiac ablation, the physician positions the catheter tip against the inner surface of the heart muscle, as close as possible to the area to be treated. The radiofrequency current is delivered through the catheter tip to the cardiac muscle. Perforation of the heart muscle is a complication.
Because treatment to certain areas can cause the heart to beat too slowly, insertion of a permanent pacemaker may be necessary. This complication is rare and occurs in less than 1 percent of cardiac ablation for certain arrhythmias.
