Before the procedure
Cardiac ablation usually takes place in a special room called an electrophysiology lab, often in a hospital. A healthcare professional places an IV in a vein, often in the hand or forearm. Fluids and medicines to help you relax, called sedatives, flow through the IV.
The type and amount of sedation you need depends on the rhythm, the procedure, the medical center's available options and your overall health. You may be lightly or deeply sedated. Some people get general anesthesia, which puts them in a sleeplike state.
During the procedure
During cardiac ablation, a doctor who is a heart rhythm specialist, called an electrophysiologist, places one or more thin, flexible catheters into a blood vessel and guides them to the heart. The catheters usually enter through a blood vessel in the groin. A blood vessel in the upper chest or neck area may be used for some procedures.
Tiny sensors at the catheter tips, called electrodes, record electrical signals in the heart. Your doctor and care team use this information to understand the rhythm and find the areas to treat. This important step is called an electrophysiology (EP) study. It's like making a map of the heart's electrical system.
Next, your doctor uses an ablation method suited to the rhythm.
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Radiofrequency ablation uses controlled heat to treat heart tissue.
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Cryoablation uses extreme cold to freeze heart tissue. A balloon may be inflated near the pulmonary veins to isolate them during atrial fibrillation ablation. This is called cryoballoon ablation.
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Pulsed field ablation uses short, high-energy electrical pulses. It's generally used to perform pulmonary vein isolation during atrial fibrillation ablation. Researchers continue to study other uses.
The treated areas interrupt faulty electrical signals so the signals can't start or maintain an irregular heartbeat.
For atrial fibrillation ablation, studies have found broadly similar results in rhythm-control results among radiofrequency ablation, cryoablation and pulsed field ablation.
Sedation or anesthesia can help reduce pain and anxiety. You may feel pressure or discomfort during parts of the procedure. Tell your care team if you have severe pain, shortness of breath or another symptom that concerns you.
Cardiac ablation often takes about 3 to 6 hours, though some procedures may be shorter or longer. The length depends on the rhythm being treated, the number of areas treated, the mapping needed and the ablation method.
After the procedure
After your procedure, you rest in a recovery area for a few hours. A care team member checks your heart rhythm, blood pressure and catheter entry site. You may go home the same day. Some people stay overnight. Whether you go home the same day or stay overnight depends on the procedure and recovery period. Ask your healthcare team how long you will need to stay in the hospital. Also, plan to have someone drive you home.
You may feel a little sore or have some bruising or swelling at the catheter entry site as you recover after the procedure. The soreness often improves within a week. Most people can go back to their daily activities within a few days. Do not lift anything heavy for about a week. Follow your care team's instructions.
During the first eight weeks after atrial fibrillation ablation, irregular rhythms may happen and may stop over time. An early episode may not mean the ablation failed.
Your healthcare team tells you how to care for the catheter entry site. Call 911 or get emergency medical help right away if bleeding does not slow down when you put pressure on it. Follow your care team's instructions for when you return home and watch for any other warning signs, such as severe chest pain, trouble breathing or signs of a stroke.
Ask your care team when it is safe to drive, fly, travel, take a bath or drink alcohol. For atrial fibrillation, drinking less alcohol may help lower the chance of the irregular rhythm returning.
At follow-up appointments, your care team may monitor your heart rhythm and review your medicines. Irregular rhythms can come back soon after ablation or later, sometimes without clear symptoms. After cardiac ablation, contact your care team if fatigue or other symptoms are severe, get worse or last longer than expected.