Treatments

Catheter ablation is usually recommended for patients with arrhythmias that cannot be controlled by medication or those who suffer from arrhythmia from the upper chambers of the heart. In some cases, it may be recommended for arrhythmia that begins in the lower chambers of the heart also.

Catheter ablation is generally performed under sedation or sometime under anaesthesia.

Catheter ablation takes about 3 to 4 hours to perform.  The procedure is usually done in the Electrophysiology lab (EP lab) or in an operating room.  The patient is first administered with intravenous (IV) medications for sedation or the patient may be anaesthetised.

An area on the arm, neck or groin is numbed and a small hole is made in the skin.  A thin guide wire and 2 to 3 small catheters are guided to the heart through blood vessels.  After the catheter has been placed correctly in the heart, electrodes at the end of the catheter are used to stimulate the heart.  This helps to locate the problem areas in the heart which are causing the abnormal heart rhythm. Then, mild radiofrequency heat energy is used to destroy or “ablate” the problem area.  This area is usually quite small – about 0.5 cm. Once the problem area is destroyed, the abnormal electrical signals that caused the arrhythmia can no longer be sent to the rest of the heart.

Most patients do not feel any pain during the procedure.  There may however be a mild sense of discomfort in the chest.  After the ablation is over, the guide wire and catheters are removed.

After the Surgery

After the procedure, the patient will be required to lie still for about 6 hours to reduce the risk of bleeding.  Pressure may be applied to the site where the catheter was inserted. The patient will be monitored closely during recovery.  Some patients can go home on the same day of the procedure while some others may be required to stay at the hospital for a day or two.

Rehabilitation

Rehabilitation after catheter ablation is usually fairly straightforward.  In the days after the procedure, there may be mild symptoms such as an achy chest and discomfort or bruising in the area where the catheter was inserted.  The patient may also notice skipped heart beats or irregular heart rhythms. Most patients can return to normal activity within a few days.

Risks / Complications

The risk of complication from catheter ablation is very low.  Serious complications, including infection and bleeding at the incision site, are uncommon.  Temporary side effects can include weakness and numbness in the legs and swelling and bruising at the incision site.

Outlook

Catheter ablation, in otherwise healthy patients, is usually an uneventful procedure.  But it is important to follow all the instructions given by the doctor after the procedure.  Follow-up visits and medication schedules should be strictly adhered to. Even physical activity should be undertaken only upto the prescribed safe levels.