Cardiac ablation, or catheter ablation, is a nonsurgical procedure to cure heart rhythm disorders caused by abnormal electrical signals. According to the National Heart, Lung and Blood Institute, or NHLBI, cardiac ablation involves sending high-energy pulses through an electrode in a catheter to kill selected heart muscle cells that are causing the abnormal electrical signals. Contraindications are factors that exclude patients from a treatment. Patients may not be suitable candidates for cardiac ablation due to the type of heart condition they have, age or other diseases they have or if other less risky treatments are available.
Exclusion by Condition
According to Cleveland Clinic, only patients with certain heart rhythm disorders that cause the heart to beat in a rapid or unsynchronized manner benefit from catheter ablation. These include patients with a type of fast heartbeat, or tachycardia, called AV nodal re-entrant tachycardia. An extra signaling path that causes the electrical current to travel in a circle causes this condition. Similarly, patients with extra signaling paths, called accessory pathways that incorrectly connect the upper and lower chambers of the heart, benefit from ablation. Patients with a rapid, random signaling that causes atrial flutter or quiver, called atrial fibrillation, are also good candidates for cardiac ablation. Patients whose irregular heartbeats stem from other causes, or who have other heart conditions, are not likely to benefit from an ablation procedure, notes Cleveland Clinic.
Medication Tolerance
The NHLBI explains that if the irregular heart rhythm is well controlled with medications, patients who are able to tolerate the drugs and the regimen are not likely to gain greater benefits from cardiac ablation.
Age
Although age by itself is not strictly a contraindication for ablation therapy, the NHLBI states that the risks of complications are higher when patients are 75 or older. Depending on overall health, and other circulatory problems present, if catheter ablation is likely to cause bleeding, damage to blood vessels or blood clots, the patient may be not be a good candidate for the procedure.
Other Diseases
The NHLBI notes that diabetes and kidney disease may increase the risks of cardiac ablation. Similarly, patients with heart conditions that are currently treated with anti-blood-clotting medications may not be good candidates for ablation procedures.
Length of Disease, Severe Obesity
According to an online article by Dr. Dhiraj Gupta, consulting cardiologist at the Liverpool Heart and Chest Hospital in the United Kingdom, other contraindications for cardiac ablation include patients who have had atrial fibrillation longer than two or three years or those with an enlarged left upper heart chamber. Likewise, he says, severely obese patients or those having two or all three of these conditions would be considered to have absolute contraindications for cardiac ablation.
