Ablation Therapy for Arrhythmias (cont.)
Why Do I Need Ablation Therapy?
Doctors recommend ablation therapy to treat:
- Atrial fibrillation and atrial flutter
- AV Nodal reentry tachycardia (AVNRT)
- Accessory pathways
- Ventricular tachycardia
How Should I Prepare for Catheter Ablation?
- Ask your doctor which medications you should stop and
when to stop them. Your doctor may ask you to stop certain medications (such
as those that control your heart rate or aspirin products) one to five days
before your procedure. If you are diabetic, ask your doctor how you should
adjust your diabetic medications.
- Do not eat or drink anything after midnight the
evening before the procedure. If you must take medications, drink only with a
small sip of water.
- When you come to the hospital, wear comfortable clothes. You
will change into a hospital gown for the procedure. Leave all
jewelry and valuables at home.
What Can I Expect During Catheter Ablation?
- The procedure will take place in a special room called
the EP (electrophysiology) lab. Before the test begins, a nurse will help you
get ready. You will lie on a bed and the nurse will start an IV (intravenous)
line. This is so the doctors and nurses can give you medications and fluids
through your vein during the procedure. You will be given a medication through
your IV to help you relax. Depending on the type of ablation you have, you may
or may not be awake during your procedure. If you are awake, you will be asked
to report any symptoms, answer questions or follow instructions given to you
by your doctor. If you are uncomfortable or need anything, please let your
nurse know.
- The nurse will connect you to several monitors.
- After you become drowsy, your groin area will be
shaved and you neck, upper chest, arm and groin will be cleansed with an
antiseptic solution. Sterile drapes will be placed to cover you from your neck
to your feet.
- The doctor will numb the insertion site by injecting a
medication. You will feel an initial burning sensation, and then it will
become numb. Then, several catheters (special wires that can pace the heart
and record its electrical activity) will be inserted into a large blood
vessel(s) and or artery (in your groin, neck or arm) and advanced to your
heart. If you are awake, it is important that you remain still and resist the
temptation to raise your head to see what the doctor is doing while the
catheters are being placed.
- After the catheters are in place, the doctor will look
at the monitor to assess your heart's conduction system.
- Then, the doctor will perform the ablation procedure.
- During traditional ablation, the doctor will use a pacemaker to give the heart
electrical impulses to increase your heart rate. You may feel your heart
beating faster or stronger when you are paced. If your arrhythmia occurs, the
nurse will ask you how you are feeling. It is very important to tell the
doctor or nurse the symptoms you feel. The doctor will then move the catheters
around your heart to see which area(s) your arrhythmia is coming from. Once
the doctor finds the area of your arrhythmia, energy is applied. You may feel
some discomfort or a burning sensation in your chest, but you must stay quiet,
keep very still and avoid taking deep breaths. If your pain is extreme, tell
your nurse or doctor and they may give you more medication to help you.
- During pulmonary vein ablation (for atrial fibrillation), the
doctor delivers energy through a catheter to the area of the atria
that connects to the pulmonary vein (ostia), producing a circular
scar. The scar will then block any impulses firing from within the
pulmonary vein, thus preventing atrial fibrillation from occurring.
The process is repeated to all four pulmonary veins. In some cases,
ablation may also be performed to other parts of the heart such as
the subclavian veins and coronary sinus. The catheter is a special
"cool tip" catheter. Fluid circulates through the catheter to help
control the intensity of the temperature. Once the ablation is
complete, the electrophysiologist will use monitoring devices to
observe the electrical signals in the heart and evaluate if the
signals are coming from areas around the pulmonary veins or are
originating, as they should, from the sinus node.
The procedure usually takes about four to eight hours, but sometimes
longer.
Next: What happens after catheter ablation? »
- Pacemaker - Learn about the pacemaker - an electronic device used to treat patients with abnormally slow or irregular heartbeats on MedicineNet.com
- Arrhythmia (Irregular Heartbeat) - Arrhythmia (irregular heartbeat or abnormal heart rhythm) symptoms include palpitations, dizziness, fainting, shortness of breath and chest discomfort. Learn how to recognize the warning signs and treatment of arrhythmia on MedicineNet.com.
- Echocardiogram - Information on Echocardiogram including why you would need one, the types of echocardiograms, how to prepare and what to expect.
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