If you’ve just been diagnosed with Afib, you are not alone. With the increasing age and improved survival rates among patients with cardiovascular disease, instances of Afib are expected to grow significantly in the foreseeable future. Up to 69% of Afib patients on anti-arrhythmic drugs discontinue treatment due to lack of efficacy or adverse events². Catheter ablation can be a safe and effective treatment for paroxysmal Afib. Cardiac ablation targets the areas of your heart that generate faulty electrical pulses that cause rapid heartbeat or Afib. By neutralizing and blocking these areas, the pulses are controlled, and a normal heartbeat returns.As with any medical treatment, individual results may vary. Only a cardiologist or electrophysiologist can determine whether ablation is an appropriate course of treatment.
What is catheter ablation?
Catheter ablation is a noninvasive procedure that uses a thin bendable wire called a therapeutic catheter. This catheter is placed through your vein and into your heart where the electrical impulses of your heart can be studied and treated.
A 3D cardiac mapping system that acts like a navigation system is used to create a map of your heart in real time. Guided by this map, the doctor places a catheter into your heart to pinpoint the source of the abnormal electrical signals.
When the source of your Afib is located, therapeutic catheters transmit radiofrequency waves, generating enough heat to produce a small scar on the targeted part of your heart tissue. This process blocks the abnormal electrical impulses causing your heart rhythm disorder.
The ablation procedure is performed by a heart rhythm specialist called an electrophysiologist (EP). An EP is a cardiologist (heart doctor) who has had specialized training in diagnosing and treating heart arrhythmias. Your primary physician or cardiologist can refer you to an EP, or you can search for an EP in your area using the search feature to the right on this page.
Ablation is the most cost-effective therapy among patients with monthly episodes of common arrhythmias. In 2000, ablation was found to reduce lifetime medical expenditures by $27,900 compared with long-term drug therapy.
Most people who have a catheter ablation experience either:
- A long-term reduction in the number of episodes of arrhythmia and the severity of symptoms, or
- A return to normal heart rhythm
This means that, after successful catheter ablation, you may be able to stop taking medication for controlling your heart rate or rhythm, or you may be able to reduce the amount you take. Do not modify your medications without consulting your doctor.
Cardiac ablation is considered safe, so the chance of experiencing complications is very low. The electrophysiologist (EP) will discuss any risks with you before your ablation therapy. The catheter ablation procedure always begins with an electrophysiology study.
¹Hugh Calkins, Matthew R. Reynolds, Peter Spector, et al. Treatment of Atrial Fibrillation With Antiarrhythmic Drugs or Radiofrequency Ablation: Two Systematic Literature Reviews and Meta-Analyses. Circ Arrhythm Electrophysiol. 2009;2:349-361; originally published online June 2, 2009; doi: 10.1161/CIRCEP.108.824789
²Pappone C, Vicedomini G, Augello G, Manguso F, Saviano M et al. (2011) Radiofrequency catheter ablation and antiarrhythmic drug therapy: a prospective, randomized, 4-year follow-up trial: the APAF study. Circ Arrhythm Electrophysiol 4 (6): 808-814.
How do I prepare for catheter ablation?
Your doctor will tell you ahead of time whether to stop taking any of your medications. Do not modify your medications without consulting your doctor.
Often, your doctor will tell you not to eat or drink for six to eight hours before the test.
The area where the catheter will be inserted will be thoroughly cleaned and shaved. This is usually in your groin, but may be in your neck. You will receive a local anesthetic in that area.
You will be given a mild sedative. Your EP will then insert the catheters. You may initially feel some pressure at the site of insertion.
What happens during the catheter ablation procedure?
Cardiac ablation is a nonsurgical procedure that involves two key stages: mapping and ablation.
- Mapping - First, a ‘map’ of your heart is made using catheters to identify the location of the abnormal electrical signal that is causing your arrhythmia. The catheters are thin, bendable tubes that are introduced via your circulatory system. The mapping catheter has a tiny electromagnetic sensor in its tip that communicates with a 3D electroanatomical mapping and ablation system to make a picture of your heart.
The resulting map gives your EP detailed information about how your heart looks and where the electrical circuit is broken.
- Ablation - Once your EP has created a 3D map of your heart, the catheter is maneuvered to the areas identified by the map. The EP then uses radiofrequency waves to neutralize these small parts of your heart tissue that generate and conduct abnormal electrical activity. Ablation therapy blocks the faulty electrical impulses that cause your irregular heart rhythm.
The catheter ablation procedure, including the EP study and mapping, may take several hours.
What happens after my catheter ablation?
Immediately after your catheter ablation, your EP will remove the catheters and apply pressure to the insertion site to minimize or prevent bleeding. A bandage may be applied. It is important to remain still during this time.
You will most likely stay in bed for several hours, or possibly overnight, after the procedure for observation and then go home the next day. Once you are free to get up and move around, you may feel stiff from lying still for so long.
At home, you will need to limit your activity for several days and avoid all strenuous physical exertion. Most people can return to their normal routine within a few days.
It is common to have a small bruise or walnut-sized lump where the catheter was inserted. You should contact your doctor immediately if the spot becomes warm, tender, painful or swollen. You should also contact your doctor immediately if you experience fever, dizziness or any other symptoms. Be certain to follow your doctor's instructions carefully regarding any medications and follow-up appointments.
Learn more about the outcomes and effectiveness of catheter ablation.
Caution: US law restricts this device to sale by or on the order of a physician. Important information: Prior to use, refer to the instructions for use supplied with this device for indications, contraindications, side effects, warnings and precautions.
The NAVISTAR® THERMOCOOL®, EZ STEER® THERMOCOOL® NAV, THERMOCOOL® SF NAV, and THERMOCOOL SMARTTOUCH® Catheters are FDA approved for the treatment of drug refractory recurrent symptomatic paroxysmal atrial fibrillation, when used with compatible three-dimensional electroanatomic mapping systems. Catheter ablation for AF may not be an option for you if you have any of the following conditions: certain recent heart surgery; prosthetic valves; active systemic infection; certain cancers; intracardiac thrombus, or an interatrial baffle or patch. Consult your physician to find out if catheter ablation is right for you.
As with any medical treatment, individual results may vary. Only a cardiologist or electrophysiologist can determine whether ablation is an appropriate course of treatment. There are potential risks including bleeding, swelling or bruising at the catheter insertion site, and infection. More serious complications are rare, which can include damage to the heart or blood vessels; blood clots (which may lead to stroke); heart attack, or death. These risks need to be discussed with your doctor and recovery takes time.
THERMOCOOL® Navigation Catheters are indicated for the treatment of recurrent drug/device refractory sustained monomorphic ventricular tachycardia (VT) due to prior myocardial infarction (MI) in adults.