The electrophysiology (EP) study and catheter ablation are very similar procedures. In fact, your doctor may decide to do both procedures, one after the other, while you are in the EP lab. This possibility will be discussed with you prior to the study.
Catheter ablation is a non-surgical technique that destroys part of the abnormal electrical pathway that is causing your rapid heart rhythm.
During catheter ablation, doctors insert a special electrode catheter (thin, soft, coated wires) into the heart. These catheters are inserted into a vein or artery though a site in your groin, neck, shoulder, or arm. First, the area is numbed with a local anesthetic so you won't feel pain. Then, a small puncture is made in the vein or artery.
The catheter is inserted and moved toward your heart. This movement is viewed on a video screen. When the exact area to be ablated is found, the ablation can be done. They position the catheter so that it lies close to the abnormal electrical pathway, then pass radiofrequency (heat) energy through it. The tip of the catheter heats up and destroys (ablates) the small area of heart tissue that contains the abnormal pathway. The rest of the heart is unharmed. Depending on the heart rhythm problem, areas to ablate may include:
- An extra pathway or circuit
- Part of your AV node (to slow down the signals passing through this node)
- All of your AV node (to stop signals from passing thought this node)
After the ablation, the catheter or catheters are removed from your body. You'll need to remain lying down for 4 to 6 hours to allow the insertion site to seal. A nurse will check this site and your blood pressure often. Before you go home, you may have a chest x-ray and other tests. You may leave the hospital that day or you may stay one or more days.
Your doctor or the electrophysiologist will discuss your ablation with you. One ablation is usually enough to treat a heart rhythm problem. Occasionally, though, the heart rhythm problem returns or another one is found. In this case, another ablation is needed. You can usually stop taking heart rhythm medication after a successful ablation.
When it's time to go home, have an adult friend or family member ready to drive you. Most people can return to normal activities within a day or two. At home, after your ablation:
· Limit your activity during the first 24 hours after you return home. You can move about, but do not strain or lift heavy objects.
· If you notice new blood on the dressing, place your fingers over the site and press firmly for about 20 minutes. If bleeding continues, call your doctor or go to the nearest emergency room while continuing to apply pressure.
· Leave the dressing on the insertion site(s) until the day after the procedure. The nurse will tell you how to take it off and when it's okay to take a shower.
· A bruise or a small lump under the skin at the insertion site is common. It will generally disappear within 3 to 4 weeks.
· Call your doctor or nurse if the insertion site becomes painful, warm to the touch, the bruising or swelling increases, or you develop a fever over 100 oF.
· Call your doctor if you have recurrence of your rapid heart rhythm, or if you experience dizziness, chest pain, or shortness of breath.
· Be sure to check with your doctor or nurse about medications – which ones to continue and which ones to stop.
