The heartbeat is controlled by an electrical system run by a heart structure called the sinoatrial, or SA, node. The SA node normally sends out an electrical signal that triggers the heart to contract and release in a uniform pattern so that blood can move through its chambers properly. Disruptions to the electrical system can lead to an abnormal heart rhythm called an arrhythmia. Ablation surgery, also referred to as cardiac ablation or catheter ablation, is a procedure that doctors perform in an attempt to correct the heart's electrical system.
Procedure
During ablation, doctors insert a long, narrow tube called a catheter into a blood vessel located in a patient's arm, neck or upper thigh. With the aid of a fluoroscope, they guide the catheter through the blood vessel to the heart. A fluoroscope is a machine that projects live images of a catheter inside of a blood vessel. The end of the catheter contains electrodes, and when the catheter reaches the heart, these electrodes stimulate the heart and record its electrical activity. When doctors determine the source of the abnormal activity, they place the electrodes over that area and send radiofrequency waves to the heart. These waves destroy the area of the heart that is causing the abnormal signaling and help to restore normal heartbeat.
Recovery
After an ablation surgery, a patient must lie still for approximately 4 to 6 hours, according to the National Heart, Lung and Blood Institute. The absence of movement prevents excessive bleeding at the catheter insertion site. Doctors release some patients from the hospital the same day as the procedure, whereas others must stay overnight. Recovery is usually quick and most people are able to resume daily activities within a few days.
Indications
In most cases, doctors use ablation surgery to correct rapid heartbeats that begin in the upper chambers of the heart, called the atria, according to the Heart Rhythm Society. These types of arrhythmias include atrial fibrillation, atrial flutter and atrial tachycardia. Occasionally, a patient may have ablation surgery for arrhythmias that begin in the lower chambers of the heart, called the ventricles. These arrhythmias are usually more serious and can result in death of the heart tissue.
Evaluation
To determine whether ablation surgery is appropriate, a physician will perform a complete medical history review and physical examination. Patients may have an electrocardiogram, echocardiogram and heart monitor test to track the electrical activity of the heart, according to Cleveland Clinic.
Risks
As with any surgery, ablation carries potential risks. The site of the catheter insertion may bleed excessively or become infected. The heart's electrical system may also become permanently damaged, which requires lifetime use of an artificial pacemaker. The blood vessel through which the catheter is inserted may also become damaged, although this adverse effect is rare. The National Heart, Lung and Blood Institute notes that risks increase for those over the age of 75 or those with kidney disease or diabetes.
