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Catheter Ablation for a Fast Heart Rate

Treatment Overview

Catheter ablation is a procedure used to selectively destroy areas of the heart that are causing a heart rhythm problem.

Thin, flexible tubes called catheters are inserted into a vein, typically in the groin or neck. They are threaded up through the vein and into the heart. There is an electrode at the tip of each catheter. The electrode sends out radio waves that create heat. This heat destroys the heart tissue that causes the fast heart rate. Another option is to use freezing cold to destroy the heart tissue.

Catheter ablation is done in a hospital where the person can be carefully monitored. The procedure is done with an electrophysiology (EP) study, which can identify specific areas of heart tissue where the fast heart rate may start or where abnormal electrical pathways are located inside or outside the atrioventricular (AV) node. This allows doctors to pinpoint exactly what tiny area of heart muscle to destroy.

A local anesthetic is used at the site where the catheter is inserted. The person may be awake during the procedure but may be sedated or asleep.

What To Expect

You may stay in the hospital overnight. You may have swelling, bruising, or a small lump around the site where the catheters went into your body. You can do light activities at home. Don't do anything strenuous until your doctor says it is okay. This may be for several days.

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Why It Is Done

Catheter ablation is used for people who have persistent or recurrent fast heart rates.footnote 1, footnote 2, footnote 3

Ablation might be done to treat:

  • Supraventricular tachycardia (SVT).
  • Wolff-Parkinson-White (WPW) syndrome.
  • Ventricular tachycardia.

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How Well It Works

Catheter ablation can eliminate atrioventricular nodal reciprocating tachycardia (AVNRT), a type of supraventricular tachycardia, in almost all cases.footnote 4

This procedure can successfully eliminate WPW most of the time. There is a small risk of the arrhythmia recurring even after successful ablation of WPW. But a second session of catheter ablation is usually successful.footnote 4

For ventricular tachycardia, catheter ablation might make the arrhythmia happen less often or stop the arrhythmia from happening again.footnote 5

Risks

Problems during and after catheter ablation are not common. But the procedure has some risks. They include:

Some risks are more likely with certain types of supraventricular tachycardia (SVT). Your doctor can help you know your risk. You will have to decide whether the possible benefits of ablation outweigh these risks. Your doctor can help you decide.

References

Citations

  1. Al-Khatib SM, et al. (2017). 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Circulation, published online October 30, 2017. DOI: 10.1161/CIR.0000000000000549. Accessed November 6, 2017.
  2. Page RL, et al. (2015). 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. DOI: 10.1161/CIR.0000000000000311. Accessed September 23, 2015.
  3. Cronin EM, et al. (2020). 2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias. Journal of International Cardiac Electrophysiology, 59(1): 145–298. DOI: 10.1007/s10840-019-00663-3. Accessed June 28, 2021.
  4. Page RL, et al. (2015). 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. DOI: 10.1161/CIR.0000000000000311. Accessed September 23, 2015.
  5. Al-Khatib SM, et al. (2017). 2017 AHA/ACC/HRS guideline for management of patients with ventricular tachycardias and the prevention of sudden cardiac death. Circulation, published online October 30, 2017. DOI: 10.1161/CIR.0000000000000549. Accessed November 6, 2017.
  6. Brugada J, et al. (2020). 2019 ESC guidelines for the management of patients with supraventricular tachycardia. European Heart Journal, 41(5): 655–720. DOI: 10.1093/eurheartj/ehz467. Accessed December 1, 2021.

Credits

Current as of: April 13, 2022

Author: Healthwise Staff
Medical Review:
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Martin J. Gabica MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
John M. Miller MD, FACC - Cardiology, Electrophysiology

 

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