Ablation

Why ablations are done

You may need to have an ablation if you have an arrhythmia. Arrhythmias are caused by a problem in your conduction system, which sends out electrical signals that make your heart beat. If you have an arrhythmia, it can make your heart beat too slowly, too quickly, or in an irregular way.

Arrhythmias are usually treated with medication first because it can control your heart rate and make your symptoms better. Sometimes medication does not work or cannot be used and an ablation may be offered.

Atrial fibrillation is one of the most common arrhythmias that may need to be treated with an ablation.

Preparing for an ablation

Ablation is usually a common, quick and minor procedure. Talk to your healthcare professional about what you need to do before it. You can then begin to prepare, which can help reduce any stress and anxiety you may feel. Things to think about include:

• Organising transport to and from the hospital.
• Organising time off from work.
• Bringing a recent prescription of your current medications to hospital.
• Asking about what you can eat and drink before the procedure.
• Asking if you should keep taking all your medication before the procedure.

Being as prepared as possible before having a procedure can help speed up the time it takes to recover.

How ablation works

An ablation can be done quickly or it can take three or four hours to do. Depending on how long your healthcare professional thinks your procedure is going to take, you'll either be given local anaesthetic or general anaesthetic. General anaesthetic is used for an ablation that needs surgery (through an opening of the chest).

Local anaesthetic means you’ll be awake, relaxed and not feel any pain during the procedure. General anaesthetic means you’ll be asleep during the procedure. If you’re awake during the ablation, it can still be an uncomfortable experience as you may need to lie flat and keep still for some time.

The ablation usually works like this:

• A small cut is made in your groin or wrist.
• Thin, flexible tubes called catheters are put into one your veins or arteries in your groin or wrist. The catheters are moved up into the right position in your heart.
• An EP study may be done if it has not already. This is where your healthcare professional finds exactly where the problem is.
• Heat (radiofrequency energy) or freezing (cryoablation) is then used to destroy the area inside your heart that's causing the arrhythmia. This process will help block the abnormal electrical signals in that part of your heart.
• When the ablation is over, the catheters are removed. There might be a small amount of bleeding from the wrist or groin area when they are taken out. A nurse or doctor will press on the area for a short while to stop any bleeding. You should expect to see some bruising and to feel tender.

Ablation and pacemakers

During the ablation, there’s a small risk of damage to the heart's normal electrical pathways. If this happens, you may need to be fitted with a pacemaker to stop your heart from beating too slowly.

There is also a procedure known as ‘ablate and pace’. This is a planned procedure where you have the pacemaker fitted days or even weeks before the ablation. If you need this done, your healthcare professional will discuss it with you.

Ablation recovery

Ablation is usually a quick, minor procedure and recovery usually only takes a few days to a week. There are some things you need to know when it comes to recovery, like:

• Right after the procedure, you'll need to stay lying flat on your back, rest for a few hours and will usually need to stay in hospital overnight.
• Most people can begin to drive after a few days. Your doctor will let you know when it’s safe for you to drive. It might depend on the type of procedure you had and what type of vehicle you drive.
• You should avoid heavy lifting for at least two weeks after your treatment.
• You may feel tired for several days or weeks after an ablation. It can feel worrying if it takes you longer than you expected to feel back to normal, but everybody’s recovery is different.

Talk to your healthcare professional about your recovery and any questions you have.

• Whether it’s practical, emotional, or lifestyle, get support.

How quickly an ablation works

An ablation does not usually work straight away and you may have some symptoms, such as palpitations, after the procedure. After around eight to ten weeks it’ll be clear whether it’s worked or not.

If it works, your healthcare professional will talk to you about stopping some of your medication.

If the ablation does not work the first time and your symptoms either do not improve or return, you may need another ablation or to think about other treatments. Speak to your healthcare professional about your options.

Risks of an ablation

An ablation does include a small amount of risk. Speak to your healthcare professional about any risks before you decide to have the procedure. They’ll only recommend that you have this procedure if they think it’ll improve your symptoms and improve your quality of life.

The procedure can sometimes cause a little bleeding where the catheter was inserted. Some bruising is common but you may develop a small amount of blood under the skin, known as a haematoma. If your wound becomes very red and swollen, contact your healthcare professional.

Heart Helpline and other support

• Speak to our cardiac nurses by phone, callback, email or online chat on Heart Helpline (Monday to Friday, 9am to 5pm).
• Contact us to talk to our customer care advisors, find your local BHF shop and for any comments, compliments and complaints you may have.
• Speak to others with heart conditions by joining a support group or online community.
• Sign up to our Heart Matters magazine and online information packed with health and lifestyle tips.