Distinguished cardiac electrophysiologist Dr. Ian Weisberg answers your questions about catheter ablation.
Q. Medication has not helped my A-fib. Is cardiac ablation the next step for me?
Medication is the first line of treatment for most cases of atrial fibrillation, more commonly known as A-fib, but your doctor may recommend catheter ablation if medication does not work. There are several different interventions for rhythm disorders. Catheter ablation is just one of them.
Q. What is catheter ablation, exactly?
Catheter ablation is a percutaneous (through the skin, without a major incision) minimally-invasive technique to treat cardiac rhythm disorders. The interventionist makes a small (usually 3 mm, or about 1/8th inch) incision into an artery or vein in the groin, neck, or arm.
Then the doctor uses that incision to thread a specially designed catheter, a long tube, into the left atrium, the upper chamber on the left side of your heart. As the doctor locates the areas of your heart that are causing the rhythm problem, radiofrequency energy is applied through the catheter to destroy the defective heart tissue.
Q. What is the process for catheter ablation?
The procedure for catheter ablation begins the day before you come in. When you are scheduled for your ablation procedure, your doctor or your doctor’s assistant will give you some very specific instructions about not eating or drinking for 8 to 12 hours before you report to the surgical center, and also about what to wear, products not use, and regular medications you should or not take. For a safe procedure and a good result, it is essential for you to follow these instructions.
The day of the procedure, another nurse will help you get out of your street clothes and into a hospital gown, and then the nurse, a doctor, or sometimes an anesthesiologist will speak with you and obtain your consent to do the ablation. Then the nurse will take you to the operating room.
Catheter ablation is done under “twilight sedation.” You won’t be under general anesthesia, but you won’t be awake enough to remember much about the procedure, either. Catheter ablation usually takes 3 or 4 hours.
Q. Will I go home from the hospital the same day?
Catheter ablation always involves an overnight stay. This is to make sure there are no problems with the incision, and you did not develop any blood clots during the ablation.
Q. How long does it take to feel better?
Dr. Ian Weisberg advises patients that it can take about 3 months to enjoy the full benefits of cardiac ablation. You may still have some incidents of A-fib or cardiac flutter for a while. That’s because it takes several months for scar tissue to form on your heart and block the nerve impulses that are causing the abnormal rhythm.
While you are in recovery, you must continue to take any prescribed blood thinners and medications to stabilize your heart rhythm. After three months, your doctor will assess your progress and make recommendations for additional treatment, if you need it.
