Arrhythmia radiofrequency ablation is a procedure to destroy cells that cause heart arrhythmias. An arrhythmia is an irregular heart rate, such as a very fast heartbeat or a heartbeat that does not follow a consistent rhythm.
Radiofrequency ablation helps the heart return to and remain in a normal rhythm. During the procedure, doctors insert a thin catheter into the heart to target areas that are causing the arrhythmia. Heat from electrodes at the end of the catheter destroys these tissues, which helps prevent abnormal heartbeats.
The term ablation means destroying problem areas. Doctors sometimes call radiofrequency ablation
Not all arrhythmias are dangerous or require treatment. Doctors usually only recommend an ablation when other interventions do not manage or treat harmful or symptomatic arrhythmias.
This article will explain more about what arrhythmia radiofrequency ablation is and what happens during the procedure. It will explain who might need this procedure, and detail the benefits and risks of this surgery. It will also explain what a person in recovery after an arrhythmia radiofrequency ablation might expect.
Electrical signals that begin in the sinus node of the heart work by helping to generate a normal heart rate and rhythm. A normal heart rate ranges from around 60 to 100 beats per minute, though there is some variability. For example, athletes may have slightly lower heart rates, and it is possible to be healthy and have a slightly faster heart rate.
Problems with the cells that control these electrical signals may cause the heart to beat at an irregular rhythm. For example, the heart may beat too fast or skip beats.
Many heart arrhythmias develop because of abnormal cells in the heart. Catheter ablation uses heat from radiofrequency to destroy these abnormal cells.
During an arrhythmia radiofrequency ablation, people are awake, but doctors may give them a sedative. This means a person will not feel pain, and may not remember much about the procedure.
This procedure usually involves a needle puncture in a person’s groin.
The procedure happens as follows:
- A medical professional will clean, shave, and numb the groin.
- A doctor uses a needle to insert a tube into a vein or artery in the groin. The tube is about the width of a straw. As the doctor guides it up through the blood vessel, it will be visible on a video monitor. Aside from some pressure in the groin, a person should not feel any pain during this step.
- Through this tube, which is also called a sheath, a doctor inserts one or more catheters, or long, thin wires, until they reach the person’s heart.
- The doctor then sends an electrical impulse through one of these wires. It helps the doctor to see the tissue that is causing the arrhythmia by activating it or using electrical signals through the other wires.
- The doctor places the catheter exactly where the problem tissue is. The doctor then sends radiofrequency energy to that place, which does not cause the person any pain. This energy destroys the cells that are causing the problem.
According to the American Heart Organization (AHA), a radiofrequency ablation usually takes between 2–4 hours. This could be longer if a person has multiple areas within their heart that are causing the arrhythmias.
A person undergoing a radiofrequency ablation can usually go home on the same day as the procedure, but they may need to stay overnight.
Radiofrequency ablation can treat a number of arrhythmias, including:
- Atrial fibrillation: Around 2.3 million Americans have atrial fibrillation. It is more common in older adults. Some people do not experience symptoms, but some notice shortness of breath, fatigue, and lightheadedness.
- Atrioventricular junctional re-entrant tachycardia: Junctional tachycardia is a rare condition that occurs mostly in childhood.
- Ventricular tachycardia or premature ventricular contractions: Some types of ventricular tachycardia or premature ventricular contractions also respond to radiofrequency ablation. This condition involves a rapid heart rate due to problems with the ventricle.
Radiofrequency ablation is a relatively low-risk procedure that does not require general anesthesia.
Most people go home and feel fine the same day, though a person will need a ride home because it is unsafe to drive after being sedated.
Recovery is usually not complicated and may only involve mild symptoms.
For most people who have uncomplicated procedures, recovering from ablation is relatively simple. A person might feel groggy or nauseated from the sedative. They may also need to lie down for 2–6 hours immediately after the procedure to prevent bleeding.
Later, a person may notice aches in their chest or bruising at the site where the doctors inserted the sheath. However, these symptoms are usually mild.
People with less strenuous jobs can return to work within a few days, though those in more strenuous occupations may need to take more time off. It is important to follow up with a doctor to determine how much time a person needs to take.
If a person notices some arrhythmia during the recovery, they should not necessarily be concerned. It may just be the result of some inflammation in the heart following the procedure.
The success of the procedure depends on the type of arrhythmia a person has, the skill of the practitioner, whether the doctor successfully locates and destroys the dysfunctional tissue, and other factors.
The success rate for most arrhythmia radiofrequency ablations can be 90% or higher.
In people with persistent atrial fibrillation, this number may be lower, and they may need a second procedure.
Catheter ablations are relatively safe, but complications
- blood vessel damage
- heart damage
- other types of arrhythmias
Scarring near the pulmonary vein of the heart may also cause narrowing of this vein, increasing the risk of additional heart health issues. Some other less common complications
- a heart block that requires a pacemaker
- blood clots that can cause dangerous embolisms, which affect breathing and circulation
- damage to the heart
- heart attack
Radiofrequency ablation can be an effective option for treating irregular heartbeats in most people. Like most medical procedures, it poses some risks, but both the surgery and recovery period are usually very straightforward.
This procedure has a high success rate and may be effective for people who have tried medications that have not worked.
A person should talk to a doctor about the risks and benefits of this treatment.