Catheter ablation is a procedure used to
selectively destroy areas of the heart that are causing a heart rhythm problem.
Thin, flexible wires called catheters are inserted into a vein, typically in the groin or neck. They are threaded up through the vein and into the heart. There is an electrode at the tip of each wire. The electrode sends out radio waves that create heat. This heat destroys the heart tissue that causes the fast heart rate. Another option is to use freezing cold to destroy the heart tissue.
Catheter ablation is done in a hospital where the person can be carefully
monitored. The procedure is done with an
electrophysiology (EP) study, which can identify
specific areas of heart tissue where the fast heart rate may start or where
abnormal electrical pathways are located inside or outside the
atrioventricular (AV) node. This allows doctors to
pinpoint exactly what tiny area of heart muscle to destroy.
local anesthetic is used at the site where the catheter is inserted. The person
usually stays awake during the procedure but may be sedated.
Recovery from catheter ablation is
usually quick. Some people may be hospitalized for 1 to 2 days after the
procedure so doctors can monitor heart rate and rhythm. Many people go home the
Catheter ablation is often used for
people who have persistent or recurrent fast heart rates that do not respond to
drug therapy. Or it is used for people who have certain types of fast heart rates and who do not want
to take medicine.1, 2
Ablation might be done to treat:
Catheter ablation can eliminate
atrioventricular nodal reciprocating tachycardia (AVNRT), a type of
supraventricular tachycardia, in almost all
This procedure can
successfully eliminate WPW most of the time. There is a small risk of the
arrhythmia recurring even after successful ablation of WPW. But a second
session of catheter ablation is usually successful.2
For ventricular tachycardia, catheter ablation might make the arrhythmia happen less often or stop the arrhythmia from happening again.1
Catheter ablation is considered safe.
It has some
serious risks, but they are rare. They include:
You will have to decide whether the possible benefits of
ablation outweigh these risks. Your doctor can help you decide.
In catheter ablation for atrioventricular nodal reentrant
tachycardia (AVNRT), damage to the heart's conduction system requires a
permanent pacemaker in about 1 out of 100 people.2 With other
types of supraventricular tachycardia, where the abnormal cells are not close
to the heart's normal conduction system, there is almost no risk of needing a
For help on the decision to have catheter ablation, see:
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CitationsAliot EM, et al. (2009). EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias. Heart Rhythm, 6(6): 886–933.Blomström-Lunqvist C, et al. (2003). ACC/AHA/ESC
guidelines for the management of patients with supraventricular
arrhythmias—Executive summary: A report of the ACC/AHA/ESC Committee for
Practice Guidelines. Circulation, 108(15):
August 9, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & John M. Miller, MD, FACC - Cardiology, Electrophysiology
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