What to expect during a cardiac ablation procedure

Cardiac ablation is a preferred treatment option for many arrhythmias—or abnormal heart rhythms—and is particularly effective for the most common type of arrhythmia, atrial fibrillation (AFib). According to the Centers for Disease Control and Prevention, more than 12 million people in the US are projected to be living with AFib by 2030.

What is a cardiac ablation procedure?

Cardiac ablation is a treatment option for people who have been diagnosed with an arrhythmia and who may be experiencing symptoms such as chest pain, fatigue, fainting or heart palpitations. The procedure is often recommended for people who are having symptoms despite treatment with medications or as an alternative to medications. The goal of ablation is to prevent future episodes of the abnormal heart rhythm.

The most common type of ablation procedure is minimally invasive catheter ablation. The procedure is done under full anesthesia by inserting a catheter through a vein in the groin leading to the heart.

Special tools are placed in the heart to guide the catheter to the source of the arrhythmia, which in the case of atrial fibrillation is the pulmonary veins. Next, heat or extreme cold is used to create scarring around the cardiac tissue where the veins meet the heart.

The scarred tissue acts as a roadblock to the abnormal electrical signals originating in the pulmonary veins and thus keeps them out of the heart. The heart then remains in a normal rhythm. Ablation also is sometimes performed using more traditional, minimally invasive surgical techniques on the outside of the heart to create scarring.

The procedure takes a couple of hours, but you should expect to spend the full day in the hospital. After the procedure, you’ll be on bed rest for two to six hours. Some can go home the same day, while others will need to stay overnight for monitoring.

What are the risks?

Ablation has a low complication rate, with major complications only reported in 1-3% of cases. Some of the risks of cardiac ablation include:

• Damaging blood vessels
• Bleeding at the site of catheter insertion
• Heart attack
• Stroke
• Cardiac perforation (hole in the heart)
• Damaging a heart valve
• Death in rare cases

Talk to your doctor about the risks and benefits of a cardiac ablation procedure to understand if it’s the right option for you or if other AFib treatment options are a better fit.

What results can you expect?

Cardiac ablation is widely considered a safe and effective procedure to correct atrial fibrillation. The overall success rate is 70-80% in most cases. However, success rates can vary based on the duration of the AFib and other medical conditions present.

After the procedure, you will have a recovery period of about one week. There will likely be physical limitations placed by your doctor. You may have minor chest pain, shortness of breath and fatigue that may last a few days to a few weeks.

There is a three-month healing period after the procedure before it can be determined if the cardiac ablation was successful, and most patients who have ablation will still need to take blood thinners. In one-third of patients, atrial fibrillation will recur, and they will need to undergo a second procedure.

The good news is, compared to medications, a cardiac ablation procedure tends to be more effective and safer over the long term.

Ready for cardiac ablation?

It’s important to note that you will need to continue leading a heart-healthy lifestyle if you plan to undergo a cardiac ablation procedure. This includes getting evaluated for sleep apnea, limiting caffeine and alcohol, managing stress, eating a heart-healthy diet and getting regular exercise.

Talk to your doctor about what lifestyle changes can help make the procedure a success. 

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