On This Page
- Before Your Procedure: Testing
- Preparing for Your Catheter Ablation Procedure
- The Cardiac Ablation Procedure
- After Your Procedure
- What To Expect After Your Cardiac Ablation
Before Your Procedure: Testing
- Cardiac/Catheter Ablation
- What to Expect at Cardiac/Catheter Ablation
Before Your MRI
Before your MRI we will draw blood. This blood helps us see if your kidneys are healthy and working the way they should. (Your will need your blood drawn one month before your MRI.) Please also follow these instructions:
- Do not drink any caffeine 24 hours before the scan.
- Remove all metal objects (such as glasses, jewelry, belts, or clothing with zipper).
- Fill out a pre-screening form.
Remember to dress comfortably. We will also ask you to change into a hospital gown.
After those things are done, an MRI tech will place an IV in your arm (possibly two). Please tell your doctor if you have any allergies to iodine or shellfish (contrast allergies).
You will need a 13-hour medication treatment before the MRI. Also tell your doctor if you are claustrophobic or if you get anxious in tight spaces.
During MRI
During the MRI, you will be lying on your back. We will try to make you as comfortable as possible. We will put a cushion under your knees and giving you a ball that you can squeeze in your hand. The ball will alert the technician, who runs the MRI machine, if you are feeling too uncomfortable or having any problems.
The MRI machine itself is loud. We will give you headphones so you can hear the technician who runs the machine. The technician will also use the headphones to give you instructions on how to breathe during certain parts of the scan. (Breath in, breath out, hold.)
If you are cold, we can get you a blanket.
If your physician decides you can’t have a cardiac MRI, they may schedule you for a cardiac computed tomography (CT). This is also a non-invasive, painless test.
Implantable Pacemaker or Defibrillator
Note that even if you have an an implantable pacemaker or defibrillator, we can often still safely perform an MRI at University of Utah Health. However, the quality of the imaging may be lower than usual. We evaluate this on a case-by-case basis.
Transesophageal Echocardiogram (TEE): What Is TEE?
A transesophageal echocardiogram is a sonogram, and does not involve radiation. This sonogram allows your doctor to record images of your heart from inside your esophagus (food pipe).
This test looks for blood clots in your heart. It needs to be done 24–48 hours before your ablation procedure, but may instead be done as part of the ablation itself. If we find a clot in your heart, we will reschedule your ablation procedure.
Plan for the TEE to take one to two hours.
Before Your TEE
- Make a list of all your medications and check with your doctor to see if you can take them before the test.
- Don’t eat or drink for six hours before the test (this includes drinking water).
- Tell your doctor if you have ulcers, a hiatal hernia, or problems swallowing. Also, let him or her know of any allergies to any medications or sedatives.
- Plan for someone to drive you home after the exam.
During Your TEE
When you arrive for you TEE, you will change into a hospital gown. We will then take you to the testing room.
Once in the room, we will spray your throat with an anesthetic to numb it. We may also give you a mild sedative through an IV in your arm to help you relax. (You could also be given oxygen.) Then we will ask you to lay on your side.
The doctor will gently insert a probe into your mouth. As you swallow, your doctor will slowly guide the tube into your esophagus. We lubricate the tube is so that it will slide easily. You may feel the doctor moving the probe, but it shouldn’t hurt or interfere with your breathing.
A nurse will monitor your heart rate, blood pressure, and breathing. The test usually takes 20–40 minutes.
After the Test
If your TEE is the day before your ablation procedure, you can eat and drink again as soon as your throat isn’t numb. You will need someone available to drive you home after the test.
Preparing for Your Catheter Ablation Procedure
The Night Before
Do not eat or drink anything after midnight on the night before your ablation.
The Day Of
- Take only medications your doctor has told you to take with a small sip of water.
- Remove makeup and fingernail polish.
- Do not wear perfume or lotions with any fragrance.
- If you wear glasses, contacts, or dentures, bring a case to store them in.
Things to Bring With You to Your Cardiac Ablation
- Work release form (if needed)
- Any heart medical records
- List of current medications or current medication bottles (This list should include the drug name, dose, and how often you should take it.)
- Any questions you may have
- Your insurance card(s) and ID picture
Day of the Procedure
Once you arrive at the hospital, a nurse will insert an IV into your arm to give you any medications and fluids that you will need during the procedure.
Because you will be receiving fluids from an IV, your nurse will sometimes place a Foley catheter into your bladder. The catheter drains urine during the procedure and recovery.
Your nurses will shave your groin area and neck so they can insert the catheters. (A catheter is a thin, narrow, flexible wire.) We will also place multiple patches on your chest and back. These patches will monitor your heart rhythm.
From here, your nurses will take you into the procedure room and move you onto to an X-ray table. The room will be cold, but we will do everything possible to make you comfortable. We will put blankets over you to keep you warm.
The patches on your chest and back will be connected to a machine. We will also monitor your blood pressure and oxygen level.
To keep the catheter insertion sites clean, we will cover your body with a sterile drape (cloth). Another sterile cloth will rest on your head, allowing you to still see the nurse. Only the area where the catheters are inserted will be exposed.
Your nurse or anesthesiologist will then give you sedation medication through your IV to help keep you comfortable. For some ablations, you will be under general anesthesia and on a breathing machine temporarily; for others you may be only lightly sedated and more awake. Your doctor and anesthesiologist will determine the best type of anesthesia to give you during your procedure.
The Cardiac Ablation Procedure
For some patients, doctors can perform an ablation without changing your heart's rhythm. However, more commonly, your doctor will use several catheters to cause your heart to beat quickly.
This will help your doctor create an electrical map of your heart. This map helps your doctor identify what type of arrhythmia you have and where the problem. Then they can find and ablate (or destroy) damaged cells inside your heart.
After ablating (destroying) the cells that are causing problems inside your heart tissue, your doctor will prompt your heart to start beating quickly again. If your heartbeat is regular and slower, then the ablation was successful. If your heart starts beating quickly and irregularly again, you may need more ablation.
Read more about what happens during cardiac ablation.
Inserting the Catheters
To insert the catheters into your skin, your doctor will use a local anesthetic to numb your skin so you won’t feel pain. However, you will feel a little pressure. Your doctor will use a small needle to make punctures in your veins or artery. If at any time you feel pain in the groin area, let the doctor or nurse know so they can inject more numbing medication.
Your doctor will then insert multiple catheters (or wires) through these puncture sites and guide them into your heart with the help of X-ray monitors.
How many catheters you have and where we place them will depend on the type of ablation procedure you're having.
The mapping catheter locates where the abnormal signals are coming from in your heart. It marks those places on our 3D-mapping computer system. This helps us find the areas inside your heart tissue that need to be ablated (destroyed).
The ablation catheter delivers radiofrequency heating energy (or freezing energy) to create lesions. These lesions disrupt the abnormal electrical signals inside your heart. You may feel some discomfort during this part of the ablation, depending on where in the heart it is.
Often, doctors will use an intracardiac echocardiography (sonogram) through a special catheter from within the heart.
The total ablation procedure takes two to six hours, but the length of surgery depends on many factors.
During your procedure, we may ask you not to move or take deep breaths while your doctor is ablating. This is important so your doctor can make sure she is ablating the right areas.
After Your Procedure
When the procedure is finished, your doctor will remove all the catheters. They will put pressure on the areas where we inserted catheters. You will need to stay flat for two to six hours to make sure any bleeding has stopped and that your incisions (cuts) are healing well. Most patients will not need sutures (stitches).
After your procedure, you may stay at the hospital overnight so hospital staff can watch you.
Your doctor may give you a prescription before you leave the hospital. You may fill prescriptions at your regular pharmacy or the hospital pharmacy. If you would like to fill your prescriptions at the hospital, please remember to have your insurance card(s) with you as well as some form of payment.
Ablation Risks
The chances of having health problems after a catheter ablation are fairly low. Still, it’s important to discuss any possible problems you may have with your doctor before the procedure.
Possible problems may include:
- bleeding from or damage to the blood vessels where catheters were inserted; damage to the heart itself;
- damage to the heart’s working electrical system;
- additional arrhythmias;
- irritation around the heart;
- stroke or heart attack; or
- collateral (associated) damage to nearby structures, such as the esophagus, pulmonary veins, and nerves that supply the diaphragm (phrenic nerve).
What To Expect After Your Cardiac Ablation
Common Symptoms After Ablation
The ablated (or destroyed) areas of tissue inside your heart may take up to eight weeks to heal. You may still have arrhythmias (irregular heartbeats) during the first few weeks after your ablation. During this time, you may need anti-arrhythmic medications or other treatment. You may experience the following symptoms:
- Mild chest aches
- Skipping heartbeat
- Faster heartbeat
Contact your doctor if you experience any of the following:
- Increased bleeding
- Bruising or pain where your catheter was inserted (insertion sites)
- Shortness of breath or chest pain
- Coldness, swelling, or numbness in your arm or leg near the insertion site
- A bruise or lump that’s larger than a walnut close to where your catheter was inserted
- A fever of 100 F
- Symptoms of your arrhythmia
- Confusion
- Stroke symptoms
Recovery Guidelines
After your procedure you need to carefully return to your normal activities. These are general guidelines, but your doctor may modify them to suit your particular situation:
- Don’t drive for two days.
- Don’t lift more than 10 pounds for one week. (A gallon of milk is about 10 pounds.)
- Don’t exercise for one week.
- Don’t have sex for one week.
The evening of your procedure, we will ask you to start walking. In most cases, you can return to office work in two to three days.
Hear From Our Patients
In his late 20s, Parker Donat was an active guy known for his dedicated gym routine. By age 33, he was struggling to keep up with his wife Kristi during hikes—even when she had their small son strapped to her chest. Parker couldn’t figure out why he was always “dogging it.”
Read Parker's Story
Patient Resources
FAQs
What do you feel during a cardiac ablation? ›
Most people do not feel pain during the procedure. You may sense mild discomfort in your chest. After the ablation is over, your doctor will remove the guide wire and catheters from your chest.
What is the prep for a cardiac ablation? ›Before your catheter ablation procedure you will be asked to: Do not eat eating or drink for 6 hours before your procedure. Ask your doctor about taking your usual medications. If you take SGLT2 medicine for diabetes, you will need to stop taking them at least 3 days before your surgery.
How long does it take to feel normal after cardiac ablation? ›The ablated (or destroyed) areas of tissue inside your heart may take up to eight weeks to heal. You may still have arrhythmias (irregular heartbeats) during the first few weeks after your ablation. During this time, you may need anti-arrhythmic medications or other treatment.
Do and don'ts after heart ablation? ›After catheter ablation, you should avoid heavy lifting and strenuous exercise for at least three days. Talk with your provider about when it's safe to return to physical activity. After surgical ablation, you'll spend about a week in the hospital.
How long is bed rest after ablation? ›Background: After radiofrequency catheter ablation of arrhythmias, patients have to bed rest for 4-6 h to prevent bleeding and hematoma. However, such a rest may cause back pain in the patients.
How Long Does your chest hurt after cardiac ablation? ›It is common for patients to have some chest pain for 1 or 2 days. It is typically described as chest tightness that gets worse when taking a deep breath. This pain is caused by inflammation from the ablation. It should subside within a few days.
What tests are done before an ablation? ›PREPARING FOR YOUR CATHETER ABLATION
You may be asked to obtain blood test, a chest X-ray, CT scan or MRI prior to the procedure. Your doctor's office will help to coordinate the timing of the procedure and to help arrange the necessary pre-procedure studies.
Brief Summary: Catheter ablation (CA) is an established therapeutic option for patients with symptomatic atrial fibrillation (AF). During the procedure, patients are usually sedated and analgesized, most commonly by administration of Propofol combined with opioids under the supervision of the electrophysiologist.
Why is a tee done before an ablation? ›Background: Transesophageal echocardiography (TEE) is commonly used before atrial flutter (AFl) ablation to detect atrial thrombus (AT) and thereby identify a heightened risk for systemic embolism both in patients with their initial episodes of AFl and in those with prior episodes whose anticoagulation has been ...
How long does fatigue last after cardiac ablation? ›You may also have mild shortness of breath or fatigue. These symptoms are all normal and should subside within 4 to 6 weeks after the procedure. However, please tell your doctor or nurse if your symptoms are prolonged or severe, or if your abnormal heart rhythm reoccurs.
How do you sleep after cardiac ablation? ›
- If you have pain, take your pain medication about ½ hour before bedtime.
- Arrange the pillows so you can maintain a comfortable position and decrease muscle strain.
- Avoid napping too much during the day.
It is possible the nerve will regrow through the burned lesion that was created by radiofrequency ablation. If the nerve regrows, it is usually 6-12 months after the procedure. Radiofrequency ablation is 70-80% effective in people who have successful nerve blocks.
Do they shock your heart during ablation? ›Electrical cardioversion: An electrical shock is delivered to your heart through patches placed on your chest, under sedation. The shock stops your heart's electrical activity momentarily; then in most cases, the heart beat resumes at its normal rhythm.
How long do you stay on blood thinners after cardiac ablation? ›After an ablation, people typically take a blood thinner for a minimum of two months, says Dr. Ellenbogen. Because of this, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and Advil or Motrin (ibuprofen), may be limited in order to reduce the risk of bleeding.
Do you still need blood thinners after cardiac ablation? ›Catheter ablation, which destroys a small area of heart tissue that's causing the problematic beats, is recommended for high-risk patients. Patients typically continue to take blood thinners, regardless of whether the ablation procedure was effective.
What pain medicine to take after ablation? ›For most patients, non- steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin or Advil) work best to control post-operative pain.
What medication is given after an ablation? ›Antiarrhythmic drugs (amiodarone, tikosyn, propafenone, flecainide, sotalol, etc.) will be continued for a minimum of three months after the procedure.
What happens to your body after an ablation? ›You may have strong cramping, nausea, vomiting, or the need to urinate often for the first few days after the procedure. Cramping may continue for a longer time. Do not to douche, use tampons, or have sex for 2 to 3 days after an endometrial ablation, or as advised by your health care provider.
What is the downside of an ablation? ›Possible cardiac ablation risks include: Bleeding or infection at the site where the catheter was inserted. Blood vessel damage. Heart valve damage.
How long does it take the groin to heal after cardiac ablation? ›The doctor or nurse will cover the opening in your groin where the catheters went in (called the insertion site) with a small dressing. This area should heal and close in 1 to 2 days. Most patients will be able to go home the same day as the procedure.
Do you need pain meds after cardiac ablation? ›
The pain will often worsen with a deep breath and may improve with leaning forward. This is pericardial chest pain (or an inflammation around the heart lining) from the ablation and is generally not of concern. You may take an over-the-counter anti-inflammatory such as ibuprofen (Advil) or naproxen (Aleve).
Does cardiac ablation affect blood pressure? ›It may also cause transient shortness of breath, cough or high blood pressure. Reasons: ablation catheters deliver saline (salt water) with each burn; anesthesia often requires saline infusions to maintain blood pressure, and the heart can be stunned after ablation.
How long does it take to know if cardiac ablation worked? ›Some ablations work straight away. Some ablations, we need to have a blanking period of three months or so to decide whether the treatment has worked.
What type of sedation is used for ablation? ›Both the use of general anaesthesia (GA)/deep sedation and conscious sedation are viable means of conducting catheter ablation. However, ablation procedures tend to last for several hours, which can cause discomfort while requiring patients to keep still, hence favouring the use of GA or deep sedation.
Do they cut you open for a heart ablation? ›Your doctor makes several small cuts between your ribs and uses a camera to do catheter ablation. Some hospitals offer robotic-assisted surgery that uses smaller cuts and makes the procedure more precise.
Are patients awake during TEE? ›Once you're asleep, your healthcare provider will insert the probe into your mouth and pass it slowly down your esophagus. They'll move it around slightly to take pictures of your heart and blood flow. This takes about 15 minutes.
Do you have to be sedated for a TEE? ›Usually, a TEE requires only local anesthesia and moderate sedation. That means your provider will spray the back of your throat with pain-relieving medication. They'll also give you medicine through an IV to help you relax. Most people don't need general anesthesia (deep sleep).
Are headaches common after cardiac ablation? ›De novo migraine-like headache generally seems to be an uncommon complication of AF ablation involving TsP. The estimated incidence of de novo migraine-like headache after the procedure is very low (0.5-2.3%) (9-11).
Is it normal to have AFIB after heart ablation? ›Recurrent AF after catheter ablation occurs in at least 20 to 40% of patients. Repeat ablation is primarily considered for those with symptomatic AF recurrences (often drug-refactory) occurring at least 3 months or more post-ablation.
What is the life expectancy after an ablation? ›The median time from ablation to death was 11.6 days (interquartile range [IQR] 4.2–22.7).
How many ablations can you have? ›
There isn't a limit on the number of times a patient can have a catheter ablation. A patient can ask for a catheter ablation as many times as they want.
What is the risk of stroke during cardiac ablation? ›Considering that most patients submitted to AF ablation have a CHA2DS2-VASc score between 0 and 3, their estimated annual risk of stroke off anticoagulation would vary between 0.2% and 3.2%.
How long does an ablation take to perform? ›The entire ablation procedure takes 3-4 hours to perform, including the time needed to prepare for the procedure and to remove the catheters from the body.
Can a cardiac ablation cause a stroke? ›Conclusion: Although there is an increased risk of stroke in the immediate post ablation period, late strokes are less common, and the total risk of stroke is similar in patients undergoing ablation compared to matched patients treated with cardioversion.
Can Eliquis be stopped after ablation? ›Atrial Fibrillation Patients May Safely Discontinue Blood Thinners after Successful Ablation.
What is the follow up after cardiac ablation? ›Initial Follow-Up Appointment
You will be seen by your electrophysiologist at regular intervals. During these appointments, your doctor will check on your symptoms, ask you about any changes in your condition and review the results from the event monitor.
While patients who have elevated stroke risks may be able to manage symptoms of AFib — such as a racing heartbeat — with other medications or medical procedures, they will still need to take blood thinners to protect against stroke.
Is the patient awake during cardiac ablation? ›The amount of sedation needed for the procedure depends on your specific arrhythmia and other health conditions. You may be being fully awake or lightly sedated, or you may be given general anesthesia (fully asleep).
Are you conscious during ablation? ›You will receive medication for anesthesia because your movement will need to be minimized for the ablation procedure. The most commonly used method of anesthesia is deep sedation or general sedation, which puts you to sleep. Another option less commonly used is conscious sedation, which puts you in a fog.
How serious is heart ablation surgery? ›In general, cardiac (heart) catheter ablation is a minimally invasive procedure and risks and complications are rare. Catheter ablation may require an overnight stay in the hospital though most patients can return home the same day as the procedure.
How do you sleep after a heart ablation? ›
If you have pain, take your pain medication about ½ hour before bedtime. Arrange the pillows so you can maintain a comfortable position and decrease muscle strain. Avoid napping too much during the day. Remember to balance activity with rest during recovery from open heart surgery.
Can you walk after cardiac ablation? ›You can go for easy walks unless your doctor has told you not to. Avoid strenuous activity for 1 week e.g. jogging, cycling, swimming, or lifting anything over 10 pounds (4.5 kilograms). If you had an ablation, you may notice a burning in your chest.
How long are you under anesthesia for ablation? ›Median time to extubation was 9 min (first and third quartile 6-16) after procedure completed, with total anesthesia time of 116 min.
What are the negative effects of an ablation? ›- Pain, bleeding or infection.
- Heat or cold damage to nearby organs.
- A puncture injury of the wall of the uterus from surgical tools.
It may also cause transient shortness of breath, cough or high blood pressure. Reasons: ablation catheters deliver saline (salt water) with each burn; anesthesia often requires saline infusions to maintain blood pressure, and the heart can be stunned after ablation.
Are there any restrictions after an ablation? ›When you are discharged home, you should have a quiet few days resting to recover from your procedure. You can shower the next day, but should not have a bath or immerse your legs in water for at least 1 week. It is likely that you will have some chest pain and a sore throat after the ablation.
Are you intubated for cardiac ablation? ›It depends on the type of ablation. When treating atrial fibrillation or ventricular tachycardia, most doctors will use general anesthesia with endotracheal intubation and mechanical ventilation. Other ablations, like supraventricular tachycardia (SVT) and atrial flutter are mostly done using conscious (IV) sedation.
What percentage of heart ablations are successful? ›When the procedure is repeated in patients who still have atrial fibrillation after the first procedure, the overall success rate is approximately 85-90 percent. Persistent atrial fibrillation can be eliminated in approximately 50 percent of patients with a single procedure.
How long does ablation procedure take? ›How long does a catheter ablation take? The entire ablation procedure takes 3-4 hours to perform, including the time needed to prepare for the procedure and to remove the catheters from the body.
What medications are given after cardiac ablation? ›Antiarrhythmic drugs (amiodarone, tikosyn, propafenone, flecainide, sotalol, etc.) will be continued for a minimum of three months after the procedure. In many cases, antiarrhythmic drugs can be discontinued after this time period.