Cardiac Catheter Ablation

Overview

Mayo Clinic is an international leader in cardiac catheter ablation and uses the most advanced technology to treat heart arrhythmias. Most Mayo patients who undergo catheter ablation are cured of their heart arrhythmia and no longer require medication.

Catheter ablation is a minimally invasive procedure that does not require open heart surgery. In catheter ablation, catheters (thin, flexible tubes) are threaded through the patient's blood vessels to reach the heart and destroy (ablate) abnormal heart tissue.

At Mayo Clinic, catheter ablation may be used to treat:

• Atrial fibrillation
• Atrial flutter
• Supraventricular tachycardia (SVT) including AV nodal re-entry and Wolff-Parkinson-White syndrome, and certain types of ventricular tachycardia

Mayo Clinic has used catheter ablation to successfully treat thousands of patients with heart arrhythmias. Ongoing research at Mayo Clinic is focused on designing even better interventions for ablation of heart arrhythmias.

Patients benefit from the expertise and experience of the catheter ablation team at Mayo Clinic. The catheter ablation team is led by electrophysiologists (cardiologists with specialized training in the diagnosis and treatment of heart rhythm disorders). Patients also benefit from Mayo Clinic's leading-edge technology and state-of-the-art diagnosis and treatment facilities. Catheter ablation is often effective, and risks and complications such as heart injury or infection are uncommon. Physicians can advise patients on the most appropriate treatment for their condition.

Catheter ablation has numerous advantages:

• It can permanently interrupt the triggers of heart arrhythmia; many patients require no further treatment.
• It can restore a regular, coordinated heartbeat.
• For many patients, it brings freedom from long-term use of blood-thinning medications.
• The procedure is minimally invasive, and no open-heart surgery is needed.
• There is reduced risk to the patient, compared to surgery.
• The patient typically has little or no pain.
• Recovery is relatively fast; most patients leave the hospital after one or two days and resume normal activities a few days after the procedure.

The types of catheter ablation most commonly performed at Mayo Clinic include:

PVI Catheter Ablation

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• Pulmonary vein isolation ablation (PVI Ablation or PVA) — This procedure electrically isolates "hot spots" in the pulmonary veins that trigger atrial fibrillations. Pulmonary vein isolation eliminates atrial fibrillation in the majority of patients who are treated. In addition, medications that did not help patients prior to ablation may become effective.
• AV node ablation with pacemakers — AV node ablation can generally treat atrial flutter and atrial fibrillation. In AV ablation, a catheter is placed near the atrioventricular (AV) node (the electrical connection between the atria and ventricles). Radiofrequency energy is applied through the catheter to destroy the AV node, preventing the atria from sending electrical impulses to the ventricles. Doctors then need to implant a pacemaker to establish a regular rhythm. Patients will need to use a pacemaker for life. Anticoagulation (blood-thinning) medication is still required after the procedure to reduce the chance of developing blood clots.
• Ventricular tachycardia ablation — Ventricular tachycardia that cannot be managed with medication is sometimes treated with catheter radiofrequency ablation. Most patients with ventricular tachycardia will still need treatment with medications or a device such as an implantable cardioverter defibrillator after the ablation procedure.
• Supraventricular tachycardia ablation — Supraventricular tachycardia can often be treated by catheter ablation. In this procedure, catheters (long, thin tubes) are threaded through the patient's blood vessels to the heart. Radiofrequency energy is applied through the tip of the catheter to destroy (ablate) the small area of the heart that is causing the fast heart rate.

In rare cases, other types of catheter ablation may be performed, depending on the cause and severity of the patient's heart arrhythmia.

About Catheter Ablation

Cardiac catheter ablation is a minimally-invasive procedure performed to treat heart rhythm disorders. In this procedure, catheters (thin, flexible tubes) are threaded through the patient's blood vessels to reach the heart. Radiofrequency energy (heat), a laser or nitrous oxide (extreme cold) is applied through the catheter tip to the abnormal heart tissue. The energy destroys (ablates) the abnormal heart tissue causing the heart rhythm disorder.

Catheter ablation is performed by electrophysiologists (cardiologists with specialized training in the diagnosis and treatment of heart rhythm disorders). Several types of catheter ablation may be performed, depending on the cause and severity of the patient's heart rhythm disorder. Many types of heart rhythm disorders may be treated successfully by catheter ablation. Some patients may still need treatment with medications or implantable devices after the procedure.

Read more about cardiac catheter ablation at MayoClinic.com.