Cardiac ablation is a procedure that can help correct arrhythmia, which is a problem with the rhythm of a person’s heartbeat. The procedure eliminates or scars the tissue in the heart that causes arrhythmia.

There are several different types of cardiac ablation procedure. Each type helps treat a different kind of arrhythmia.

In this article, we will take a look at the different kinds of cardiac ablation surgery, as well as risks, preparation, recovery, and results.

radiofrequency is sometimes used for cardiac ablation surgeryShare on Pinterest
Image credit: BSIP/Getty Images

There are several types of cardiac ablation.

Catheter ablation

In this approach, surgeons insert long, thin tubes called catheters into blood vessels to destroy the disruptive cells in the heart.

Healthcare institutions use different techniques to eliminate cells that cause arrythmias, including:

Surgical ablation

Surgical ablation, also known as maze surgery or Cox-maze procedure, aims to eliminate atrial fibrillation (A-fib).

It is a form of open-heart surgery often performed while a person is having a surgery for additional heart problems, such as a valve replacement or heart bypass.

The maze procedure involves making small cuts in the upper chambers of the heart, called the atria. This causes scar tissue to form, which blocks the electrical signals that cause A-fib.

Some individuals undergo a minimally invasive Coxmaze procedure, often called a mini-maze, which employs smaller incisions to reduce a person’s risk of complications.

Hybrid surgical-catheter ablation

Hybrid surgical-catheter ablation combines catheter ablation, which treats the inside of the heart, with the mini-maze procedure, which treats the outer layer of the heart.

Surgeons generally use cardiac ablation to treat a range of conditions. These include:

Supraventricular tachycardia (SVT)

SVT is the most common reason for cardiac ablation surgery. It is a condition where the heart suddenly starts beating much faster than its normal resting rate of 60–100 beats per minute. The electrical signal comes from the upper chambers of the heart.

Atrial flutter

Atrial flutter is when the upper chambers of the heart beat very quickly due to faulty electrical signaling in the heart, often resulting from other heart problems, such as coronary heart disease and high blood pressure.

A-fib

A-fib is a condition that causes irregular heartbeats in the upper chambers of the heart. This increases the risk of a stroke and heart failure and can lead to an enlarged heart.

People with A-fib that does not respond to medication often pursue cardiac ablation surgery.

Other heart-related complications

People whose arrhythmias could lead to life threatening complications, such as a heart attack, are also likely to be candidates for cardiac ablation surgery.

Cardiac ablation is generally a low risk procedure. However, the risks vary with each type of treatment.

Catheter ablation

Catheter ablation is the least invasive approach and carries fewer risks than other procedures.

However, there is still a chance of damage to the heart, blood vessels, and nearby body parts, as well as of destabilization of the heart’s electrical system.

Hybrid surgical-catheter ablation

The surgery performed alongside the catheter insertion does not require a cardiopulmonary bypass. That is why this type of ablation is not as risky as other kinds of surgery may be on their own.

However, the risks associated with catheter ablation are still present.

Surgical ablation

Surgical ablation is a form of open-heart surgery. This means it involves all the risks associated with surgeries of this kind. The risks may include:

  • bleeding
  • stroke
  • infection
  • reaction to anesthetics
  • potentially fatal damage to the heart

A person preparing for cardiac ablation may need to visit the hospital about a week before surgery.

The surgeon may wish to perform tests before the procedure, including a blood test, a urine test, an electrocardiogram, and an X-ray.

It is generally advisable for a person preparing for cardiac ablation surgery to take the following steps:

  • refraining from smoking for 2 weeks before the surgery
  • refraining from eating and drinking, even water, the night before the procedure
  • not wearing scented products, such as lotions, on the day of the surgery
  • gathering things to bring to the hospital, including relevant identification and insurance documents, a complete list of medications and supplements the person takes, as well as cases to store eyeglasses or dentures

A person should consult their doctor about specific instructions for the type of surgery they are undergoing.

A person’s experience of surgery will vary greatly depending on the type of ablation.

Catheter ablation

Usually, catheter ablation lasts between 2 and 4 hours and takes place in a hospital or designated lab. A person will remain conscious throughout the procedure, but they will receive intravenous medication to cause drowsiness.

The surgeon will insert a catheter, typically through a cleansed and shaved groin, and guide it to the heart. There, pulses of energy will destroy the abnormal cells in an area measuring around one-fifth of an inch.

Hybrid surgical-catheter ablation

This approach involves two procedures, which can be spaced out or take place during one hospital stay. In the course of the surgery, the surgeon will make small incisions on the side of the chest, and the electrophysiologist will perform the catheter ablation.

Surgical ablation

Surgical ablation requires general anesthesia. In this procedure, surgeons cut the inside of the heart to create scar tissue in order to restore balance to the heart’s electrical system.

In some instances, it may be necessary to spread the person’s ribs and put their heart on a heart-lung bypass machine. However, not all surgeries are that complex.

The nature of recovery for cardiac ablation surgery depends on the type of procedure a person undergoes.

Catheter ablation

This is usually an outpatient procedure. However, a person recovering from catheter ablation will need to keep their legs straight for 6–8 hours afterward, before they can get out of bed, so most patients will stay in the hospital overnight.

People can resume most of their regular activities the day after they return from the hospital. However, they should not drive or drink alcohol for 24 hours. They should also avoid strenuous physical activity for around 3 days.

Hybrid surgical-catheter ablation

For this procedure, people stay in the hospital for 2–5 days, and recovery takes about 2 weeks.

Surgical ablation

Surgical ablation requires the most complicated healing process, with people needing 5–7 days of hospitalization and a 4-week recovery period.

While recovering, a person should get plenty of rest and avoid lifting heavy objects.

They should also follow the post-procedure instructions they receive from their doctor, which will be relevant to their situation and the procedures they have had.

Cardiac ablation surgery is generally effective. However, people may still have noticeable arrhythmias for a few weeks afterward. They may even need medication to control their symptoms.

Researchers report that catheter ablation surgery can successfully correct both short- and long-term arrhythmias.

Although people can return to work and many activities soon afterward, it can take up to 3 months after catheter ablation for the body to heal enough for the benefits of the procedure to be apparent.

The outlook for people who have cardiac ablation surgery is generally positive.

A 2015 study found a 68.6% success rate 1 year after individuals with A-fib had one procedure, a 61.1% success rate at 3 years, and a 62.3% success rate at 5 years.

Sometimes, A-fib symptoms can return. The same study found a 79% success rate 5 years after people had multiple procedures.

Cardiac ablation surgery can help correct arrhythmias, which are irregularities in the rate of the heartbeat, the rhythm of the heartbeat, or both.

Catheter ablation, surgical ablation, and a hybrid procedure combining elements of both are the basic approaches to cardiac ablation.

These procedures are generally effective for conditions such as A-fib and atrial flutter.