Ordinarily, your heart beats at a regular,
steady pace called a normal sinus rhythm that is regulated electrically
by the sinus node. When the heart beats too rapidly, the arrhythmia
is called a tachycardia. If the tachycardia originates in one
of the upper chambers of the heart, it’s called a supraventricular
(above the ventricles) tachycardia (SVT).
SVT may occur when an extra electrical pathway
exists in or between some of the structures of the heart. These
abnormal pathways can make the electrical impulses that control
your heart rate travel in a circular pattern within the heart,
causing a tachycardia. These arrhythmias can be treated, but not
cured, with medications.
Your RF Ablation
Your physician may choose to treat your arrhythmia
with a non-surgical procedure called radiofrequency ablation.
Often, this treatment permanently resolves the arrhythmia by destroying
the abnormal pathway that causes it.
A radiofrequency (RF) ablation is very similar
to an Electrophysiology (EP) Study. If you haven’t already
had an EP Study, the two procedures are frequently performed one
after the other. The EP Study helps identify the specific type
and location of the abnormal heart rhythm. Then, in a process
called mapping, a catheter (small, flexible tube) is manipulated
until it locates the abnormal pathway that is causing the tachycardia.
At this point, an ablation is performed.
A special catheter will be used to direct
radiofrequency energy to the abnormal pathway
in the heart. Radiofrequency energy is a form of electrical energy
that causes the tissue at the tip of the catheter to heat up,
permanently damaging (ablating) that small area of tissue. When
the abnormal pathway is destroyed, the heart’s electrical
impulses can only travel through the normal conduction pathways,
and the arrhythmia is eliminated.
Preparation
Before your procedure, your physician will
order an electrocardiogram
(ECG) and some blood tests, and your cardiologist or one of
the cardiology nurses will discuss the RF ablation procedure —
explaining its purpose, benefits, and potential risks. They can
also go over all medications you are taking, and give you any
special instructions concerning them. You’ll also be asked
to sign a consent form. This is a good time to ask any questions
or voice any concerns you may have.
If you’ll be coming into the hospital
as an outpatient, you’ll be told where and when to
report. You’ll be instructed not to eat or drink anything
after midnight the evening just before your procedure. You may,
however, take sips of water to swallow pills. You should plan
to be at the hospital for two to six hours (typically, the procedure
takes three to four hours), and should arrange for someone to
drive you home.
Just before your RF ablation, an intravenous
(IV) will be inserted into your arm to administer any medication.
Since you’ll be awake during the procedure, you’ll be
given a sedative to help you relax.
The area (in the groin) where the catheters will be inserted will
be washed with an antiseptic soap and shaved if necessary.
You’ll then be moved by stretcher or
wheelchair to an electrophysiology (EP) laboratory where you’ll
be positioned on a special table and covered with sterile drapes.
The entire EP staff, who have been trained specifically in the
electrical activity of your heart, will be wearing surgical hats
and masks to assure that everything remains sterile throughout
your procedure.
Procedure
The catheters used for the ablation will be
inserted through the veins in your groin. Usually, two catheters
are inserted into a vein on the right side of the groin and two
on the left. You won’t feel the catheters moving through
the blood vessels and into your heart. These catheters will be
positioned in your heart using a special type of x-ray called
fluoroscopy (live-action picture).
Controlled impulses will then be delivered
through one of the catheters to induce the suspected abnormal
heart rhythm. Once the arrhythmia is identified and located, the
RF energy will be delivered for 60 to 90 seconds at a time through
one of the catheters to the abnormal pathway. Sometimes it’s
necessary to deliver the energy several times to ablate (eliminate)
the pathway. When it appears the abnormal pathway has been ablated,
the physician will test to be certain your abnormal heart rhythm
can no longer be triggered.
Some people feel a mild, burning sensation
in the chest during the RF energy delivery. However, it’s
usually described as only mildly uncomfortable.
Throughout the entire procedure, your ECG,
heart rate, blood pressure, and oxygen level will be constantly
observed on monitors in the laboratory. Although an ablation is
usually not painful, you may experience some discomfort from lying
still for a long time. Be sure to notify the staff of any discomfort
you have at any time during the procedure.
Your Recovery
After the ablation is completed and the catheters
are removed, pressure will be applied to the insertion site to
prevent bleeding. You’ll then be taken back to your room
or to a recovery area and required to stay in bed for two to three
hours, keeping your head on a pillow and your legs straight. During
this time, you’ll be given something to eat and drink, and
your heart will be monitored. If you feel any warmth, pain, or
swelling at the catheter insertion site, be sure to tell your
nurse immediately.
Depending upon the type of arrhythmia and
location of the ablation, you will usually stay in the hospital
overnight for observation. Before leaving the hospital, you’ll
be given detailed instructions about caring for the incision site.
Your physician will also explain follow-up
plans and discuss what signs & symptoms should be reported.
Your Good Health
Your RF ablation should restore your heartbeat
to the regular rhythms necessary to pump oxygen-rich blood throughout
your body. However, you also play an important role in staying
healthy. Be sure to keep all appointments for exams and follow-up
tests. Follow your instructions, don’t hesitate to talk about
your concerns, and immediately report any new symptoms.
As always, if you have any questions about
your health, be sure to ask your physician.
If you are a Munson Healthcare patient and have a compliment,
concern, or complaint, please contact one of our Patient
Liaisons.
