Cardiac Ablation

Cardiac ablation is done in the following cases:

• Supraventricular tachycardia (the heart beats much faster than its normal heart rate, starting above the two lower heart chambers)

• Atrial flutter (when the upper chambers of the heart beat too rapidly)

• Atrial fibrillation (a rapid, irregular heart rate causing a poor flow of blood)

• Heart attack caused due to arrhythmia
  

1. Physical examination: The heartbeat of the patient is checked using a stethoscope. The patient’s symptoms, medical history, and family history are taken down.

2. Blood tests and urine tests: These tests help in checking for any underlying diseases or infections.

3. Chest x-ray, cardiac MRI, and cardiac CT angiography: These are imaging tests done to obtain clear images of the heart and the blood vessels in and around the heart.

4. Electrocardiogram (ECG): It helps in recording the electrical activity of the heart and checking if there are any heart problems.

5. Echocardiogram: Sound waves for creating images of the heart in motion.

6. Transesophageal echocardiogram: An ultrasound probe is placed down the throat to make sure that there are no blood clots present before cardiac ablation is performed.
   

The procedure for the different types of cardiac ablations are as follows:
1. Catheter ablation:

• Certain medications are injected into the veins (given intravenously) of the patient.
• The patient will feel drowsy during the procedure due to the medicines injected.
• The surgeon inserts a thin tube, known as a catheter, through the groin area, and the catheter is then guided to the heart using imaging tests.
• Once the catheter reaches its desired position, the pulses of energy (either cold or heat) are provided to kill the abnormal cells in that area.
• This procedure takes approximately 2 to 4 hours to complete.

2. Surgical ablation:

• This procedure is done under general anesthesia (the patient is completely asleep during the procedure).
• The surgeon makes a cut or incision on the inside of the heart to create scar tissue.
• This scar tissue restores the balance to the electrical system of the heart.
• In some cases, a heart-lung bypass machine is required to take over the function of the heart and lungs.
• However, all surgeries will not require a bypass machine.

3. Hybrid surgical-catheter ablation:

• Two procedures will be performed in this type of treatment.
• Small cuts are made by the doctor on the side of the chest, and a catheter ablation procedure is then performed.
• Both the procedures can be done during a single stay in the hospital, or can be spaced out.

The different complications, depending on the type of procedure performed, may include:

1. Catheter ablation: 

• Damage to the blood vessels
• Damage to the heart
• Damage to the nearby organs and tissues of the body
• Electrical system of the heart gets destabilized

2. Surgical ablation: 

• Infection
• Bleeding
• Allergic reactions to an anesthetic agent
• Blood clot formation
• Stroke (the blood supply to the brain is stopped)
• Heart attack
• Death

3. Hybrid surgical-catheter ablation: 

• Damage to the nearby heart, blood vessels, and tissues
• Destabilization of the electrical system of the heart

The post-procedure recovery and healing depend on the type of procedure performed. The post-procedure steps for each type of procedure are as follows:

1. Catheter ablation:

• The procedure is done on an outpatient basis, that is, the patient goes home on the same day of the procedure.
• The patient needs to keep the legs straight for six to eight hours after the procedure, and only then get out of bed.
• The patient can resume his/her daily activities on the next day of the procedure.
• Avoid heavy lifting and strenuous activities for at least three days after the procedure.
• Avoid driving for at least one day after the procedure.
• Avoid the consumption of alcohol at least one day after the procedure.

2. Surgical ablation:

• The patient usually stays in the hospital five to seven days after the surgical ablation.
• Avoid heavy lifting and strenuous activities during the recovery period.
• Complete recovery may take about a month.
• All the post-surgery instructions about diet, medications, and lifestyle that are given by your doctor should be followed.
• It may take approximately three months before the results of the procedure become visible.

3. Hybrid surgical-catheter ablation:

• The patient needs to stay in the hospital for two to five days after this procedure.
• Complete recovery may take about fifteen days.