Stanford Cardiac Arrhythmia Service

Catheter Ablation

Stanford electrophysiologists are at the forefront of performing catheter ablation, a non-surgical technique used to pinpoint and interrupt arrhythmias such as atrial tachycardia, atrial fibrillation and atrial flutter.

The location and type of arrhythmia determine if catheter ablation is a good treatment option for you. In many cases, this option is preferable to medication, which can have side effects.

Ablation eliminates the ability of the abnormal electrical pathway to conduct. Your physician determines the exact location during an electrophysiology study (EPS) and, when possible, he or she will perform the ablation right after the study. The ablation works by creating a lesion or scar in the location of the electrical cells that are causing the arrhythmia.

How it works

Heat energy is transmitted through the catheters, burning or “erasing” the electrical cells that are believed to be causing the arrhythmia. Once these cells are damaged, they can no longer conduct, and should be unable to produce arrhythmias.

Tachycardias which may be curable using ablation include:

Catheter ablation can also help manage atrial fibrillation. The most common method is to perform intentional AV blocking by ablating the AV node and supplementing it with a pacemaker. Newer techniques to cure atrial fibrillation with ablation are also available.

Preparing for the procedure

You prepare for an ablation in the same way you would prepare for the EPS procedure. You’ll undergo a series of tests, including a blood test and an electrocardiogram. Please do not eat or drink anything for eight hours prior to the procedure. Also, you should consult with the electrophysiologist or arrhythmia nurse five days before the procedure to determine whether or not you’ll need to discontinue any medications you may be taking. Once you and your physician have discussed the procedure and specific risks and you’ve had any questions answered, you’ll be required to sign an informed consent form.

During the procedure

The ablation procedure is done in conjunction with an EPS. The catheter ablation usually adds one to two hours to the procedure. During the electrophysiology procedure, we will reproduce your fast heart rhythm and attempt to identify the specific area in your heart that is initiating it.

Once we’ve located the area, we’ll “ablate” it by placing an electrode catheter into the area and sending radiofrequency energy (heat) to the arrhythmia focus. We’ll continue to apply this heat until that tissue is rendered unable to initiate a fast rhythm. After we have ablated the area, we’ll wait 30 minutes and then attempt to reproduce the fast heart rhythm again. If we’re unable to produce a fast heart rhythm, we’ll consider the ablation procedure successful.

After the procedure

After the procedure, we’ll remove the catheters and take you to a monitored unit for observation. In most cases, we’ll want to observe your heart monitor overnight. If there are no concerns in the morning, you can go home.

You may experience slight chest pain for a few days following the procedure. If you experience such a symptom, please notify us. Many patients experience skipped heart beats for several months following catheter ablation. If you have a recurrence of your fast heart rhythm, you should notify your regular physician or contact us at (650) 723-7111.

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