What is a Catheter Ablation?
Stanford electrophysiologists are at the forefront of performing catheter ablation, a non-surgical technique used to pinpoint and interrupt specific arrhythmias. The location and type of arrhythmia determine if catheter ablation is a treatment option for your condition. In many cases, this option is preferable to medication which can have side effects.
The potentially curative ablation procedure eliminates the ability of the abnormal electrical pathway to conduct. Your physician determines the exact location during the electrophysiology study and, when possible, the ablation will be performed right after the study. The ablation is performed by creating a lesion or scar in the location of the electrical cells that are causing the arrhythmia.
The heat energy is transmitted through the catheters. It burns or "erases," the electrical cells that are believed to be causing the arrhythmia. Once these cells are damaged, they are no longer capable of conduction and therefore should be unable to produce arrhythmias. Tachycardias amenable to the curative ablation include WPW syndrome, AVNRT, atrial tachycardia, atrial flutter, and some ventricular tachycardias. Atrial fibrillation can also be managed with catheter ablation. The most common method is to perform intentional AV block by ablating the AV node and supplementing it with a pacemaker. Newer techniques to cure atrial fibrillation with ablation are also available.
How do I prepare for the procedure?
Preparing for an ablation is the same as preparing for the electrophysiology study (EPS) procedure (see Electrophysiology Study section, page 12). You will undergo a series of tests, including a blood test and an electrocardiogram. Please do not eat or drink anything for eight hours prior to the procedure. Also, you should consult with the electrophysiologist or arrhythmia nurse five days before the procedure to determine whether or not you will need to discontinue any medications you may be taking. Once you and your physician have discussed the procedure and specific risks and your questions have been answered, you will be required to sign an informed consent form.
What happens during the procedure?
The ablation procedure is performed in conjunction with an EPS (please review the Electrophysiology Study section, page 12). The catheter ablation usually adds 1-2 hours to the procedure. During the electrophysiology procedure, we will reproduce your fast heart rhythm and attempt to identify the specific area in your heart that is initiating it. Once we have located the area, we will "ablate" it by placing an electrode catheter into the area and sending radiofrequency energy (heat) to the arrhythmia focus. We will continue to apply this heat until that tissue is damaged and unable to initiate a fast rhythm. After we have ablated the area, we will wait 30 minutes and then attempt to reproduce the fast heart rhythm again. If we are unable to produce a fast heart rhythm we will consider the ablation procedure successful.
What happens after the procedure?
After the procedure, we will remove the catheters and take you to a monitored unit for observation. In most cases, we will want to observe your heart monitor overnight and, if there are no concerns in the morning, you will be free to go home. Please see page 15 for the post-procedure treatment regimen and guidelines for discharge.
You may experience slight chest pain for a few days following the procedure. If you experience such a symptom, please notify us. Many patients experience skipped heart beats for several months following catheter ablation. If you have a recurrence of your fast heart rhythm, you should notify your regular physician or contact us at 650-723-7111.