Cardiac ablation is a procedure that can correct heart rhythm problems (arrhythmias). Ablation usually uses long, flexible tubes (catheters) inserted through a vein in your groin and threaded to your heart to correct structural problems in your heart that cause an arrhythmia.

Cardiac ablation works by scarring or destroying tissue in your heart that triggers an abnormal heart rhythm. In some cases, ablation prevents abnormal electrical signals from traveling through your heart and, thus, stops the arrhythmia.

Cardiac ablation is sometimes done through open-heart surgery, but it's often done using catheters, making the procedure less invasive and shortening recovery times.

When your heart beats, the electrical impulses that cause it to contract must follow a precise pathway through your heart. Any interruption in these impulses can cause an abnormal heartbeat (arrhythmia), which can sometimes be treated with cardiac ablation.

Ablation isn't usually your first treatment option. Ablation is a treatment option for people who:

  • Have tried medications to treat an arrhythmia without success
  • Have had serious side effects from medications to treat arrhythmias
  • Have certain types of arrhythmias that respond well to ablation, such as Wolff-Parkinson-White syndrome
  • Have a high risk of complications from their arrhythmias, such as sudden cardiac arrest

Cardiac ablation does carry risks, which include:

  • Bleeding or infection at the site where your catheter was inserted
  • Damage to your blood vessels where the catheter may have scraped as it traveled to your heart
  • Puncture of your heart
  • Damage to your heart valves
  • Damage to your heart's electrical system, which could worsen your arrhythmia and require a pacemaker to correct
  • Blood clots in the legs or lungs (venous thromboembolism)
  • Stroke or heart attack
  • Narrowing of the veins that carry blood between your lungs and heart (pulmonary vein stenosis)
  • Damage to your kidneys from dye used during the procedure
  • Death in rare cases

Your risk of having these complications may increase if you have diabetes or kidney disease.

Your doctor will evaluate you and may order several tests to evaluate your heart condition. Your doctor will discuss with you the risks and benefits of cardiac ablation.

You'll need to stop eating and drinking about six to eight hours before your procedure. If you take any medications, ask your doctor if you should continue taking them before your procedure.

Your doctor will let you know if you need to follow any other special instructions before or after your procedure. In some cases, you'll be instructed to stop taking medications to treat a heart arrhythmia several days before your procedure.

If you have an implanted heart device, such as a pacemaker or implantable cardioverter-defibrillator, talk to your doctor to see if you need to take any special precautions.

During the procedure

Catheter ablation is performed in the hospital. Before your procedure begins, a specialist will insert an intravenous line into your forearm or hand, and you'll be given a sedative to help you relax.

After your sedative takes effect, your doctor or another specialist will numb a small area near a vein on your groin, neck or forearm. Your doctor will insert a needle into the vein and place a tube (sheath) through the needle.

Your doctor will thread catheters through the sheath and guide them to several places within your heart. Your doctor may inject dye into the catheter, which helps your doctor to see your blood vessels and heart using X-ray imaging.

The catheters have electrodes at the tips that will be used during the procedure. Once in place, the electrodes will send electrical impulses to your heart and record your heart's electrical activity. This will help your doctor to find the abnormal heart tissue that is causing the arrhythmia in your heart.

Once the abnormal heart tissue that's causing the arrhythmia is identified, your doctor will aim the catheter tips at the area of abnormal heart tissue. Energy will travel through the catheter tips to create a scar or destroy the tissue that triggers your arrhythmia.

In some cases, ablation blocks the electrical signals traveling through your heart to stop the abnormal rhythm and allow signals to travel over a normal pathway instead.

The energy used in your procedure can come from:

  • Heat (radiofrequency)
  • Lasers
  • Extreme cold (cryoablation)

Cardiac ablation usually takes two to four hours to complete, but complicated procedures may take longer. During the procedure, it's possible you'll feel some minor discomfort when the dye is injected in your catheter or when energy is run through the catheter tips. If you experience any type of severe pain or shortness of breath, you should alert the cardiologist performing the procedure.

After the procedure

Following your procedure, you'll be moved to a recovery area where you'll need to lie still for four to six hours to prevent bleeding at your catheter site. Your heartbeat and blood pressure will be monitored continuously to check for complications of the procedure.

Depending on your condition, you may be able to go home the same day as your procedure, or you may need to stay in the hospital for one day. If you go home the same day, plan to have someone else drive you home after your procedure.

You may feel a little sore after your procedure, but the soreness shouldn't last more than a week. You'll usually be able to return to your normal activities within a few days after having cardiac ablation.

Although cardiac ablation can be successful, some people need repeat procedures. You may also need to take medications, even after you've had ablation.

To keep your heart healthy, you may need to make lifestyle changes that improve the overall health of your heart, especially to prevent or treat conditions that can cause or worsen arrhythmias, such as high blood pressure. Your doctor may suggest that you:

  • Avoid caffeine
  • Use less salt, which can help lower blood pressure
  • Increase your physical activity
  • Quit smoking
  • Avoid drinking alcohol
  • Eat heart-healthy foods
  • Maintain a healthy weight
  • Manage strong emotions, such as anger
  • Expertise and experience. Mayo Clinic doctors have expertise and experience in treating heart rhythm disorders using cardiac ablation and other treatments. Doctors perform more than 1,300 cardiac ablations each year.
  • Team approach. Mayo Clinic doctors trained in heart conditions (cardiologists), cardiologists trained in heart rhythm disorders (electrophysiologists) and other doctors work closely to treat people with heart rhythm disorders.
  • Technology. Doctors at Mayo conduct cardiac ablation using advanced technology in the electrophysiology laboratories.
  • Research. Mayo doctors study new and improved techniques for cardiac ablation and conduct clinical trials.

Mayo Clinic in Rochester, Minn., is ranked among the Best Hospitals for heart and heart surgery by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

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Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Doctors trained in cardiovascular diseases treat people who have heart rhythm disorders at Mayo Clinic in Arizona. Staff in the Arrhythmia Clinic and electrophysiology laboratory evaluates and treats people who may need cardiac ablation.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Doctors trained in cardiovascular diseases treat people with heart rhythm disorders at Mayo Clinic in Florida. Staff in the Cardiac Electrophysiology and Pacemaker/Defibrillator Services performs electrophysiology tests, cardiac ablation and other procedures to evaluate and treat people with heart rhythm disorders.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Doctors trained in cardiovascular diseases treat people with heart rhythm disorders at Mayo Clinic in Minnesota. Staff in the Heart Rhythm Clinic evaluates and treats adults and children with all types of heart rhythm disorders. Staff in the Electrophysiology and Arrhythmia Ablation Laboratory conducts electrophysiology tests, cardiac ablation and other procedures to treat people with heart rhythm disorders.

Doctors trained in pediatric cardiology and cardiovascular surgery treat children with heart rhythm disorders at Mayo Clinic in Minnesota. Staff in the Electrophysiology and Arrhythmia Ablation Laboratory conducts electrophysiology tests, cardiac ablation and other procedures to diagnose and treat children with heart rhythm disorders.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Doctors and surgeons trained in heart rhythm disorders study genetics, causes, diagnosis and treatment options for heart rhythm disorders and new and improved techniques for cardiac ablation. Read more about heart rhythm disease research and cardiovascular research.

See a list of publications by Mayo authors on cardiac ablation on PubMed, a service of the National Library of Medicine.

May 16, 2014