What happens when I arrive?
You will lie on a bed, and the nurse will start an intravenous line (IV) in your arm. The IV is used to deliver medications and fluids during the procedure.
A medication will be given through your IV to make you feel drowsy, and you may fall asleep.
Your neck, upper chest, arm and groin will be cleansed with an antiseptic solution, and the catheter insertion site(s) will be shaved. Sterile drapes will be placed to cover you from your neck to your feet.
Where is the procedure performed?
The catheter ablation takes place in a special room called the electrophysiology (EP) lab.
Will I be monitored?
The nurse will connect you to several monitors that will constantly check your heart rhythm and your body’s responses to any arrhythmias you may have during the procedure.
Monitors Used During the Procedure
- Defibrillator/pacemaker/cardioverter: Attached to one sticky patch placed on the center of your back and one on your chest. This allows the doctor and nurse to pace your heart rate if it is too slow, or deliver energy to your heart if the rate is too fast.
- Electrocardiogram (EKG): Attached to several sticky electrode patches placed on your chest, as well as inside your heart. Provides a picture on the monitors of the electrical impulses traveling through the heart.
- Blood pressure monitor: Connected to a blood pressure cuff on your arm. Checks your blood pressure throughout the ablation.
- Mapping system: State-of-the-art technology that helps your doctor locate the exact area of your arrhythmia.
- Oximeter monitor: Attached to a small clip placed on your finger. Checks the oxygen level of your blood.
- Fluoroscopy: A large X-ray machine will be positioned above you to help the doctors see the catheters during the procedure.
- Intracardiac ultrasound: Performed by a catheter inserted into the heart. Intracardiac ultrasound is used throughout the procedure to view the structures of the heart and the catheter when it is in contact with the heart lining.
How does the doctor insert the catheters?
After you become drowsy, the doctor will numb the catheter insertion site(s) by injecting a medication. The doctor will insert several catheters through a small incision into a large blood vessel (in your groin, neck or arm, depending on the type of ablation procedure being performed). It may be necessary to use both an artery and a vein. A transducer is inserted through one of the catheters so intracardiac (inside your heart) ultrasound can be performed during the procedure. The ultrasound allows the doctor to view the structures of the heart.
The catheters are passed through the blood vessels to your heart. After the catheters are in place, the doctor looks at a monitor to check your heart’s conduction system. The doctor then uses a pacemaker-like device to send electrical impulses to the heart to increase the heart rate.
If your arrhythmia occurs during the procedure, you’ll be asked to describe the symptoms you feel.
The doctor uses the catheters to locate the area or areas where the arrhythmia is originating. Once the area is located, energy is applied through the catheter to stop the abnormal impulses.
Once the ablation is complete, the electrophysiologist uses monitoring devices to observe the electrical signals in the heart to ensure that the abnormal rhythm was corrected.
What will I feel?
You will feel a burning sensation when the doctor injects medication in the catheter insertion site. You may feel your heart beating faster or stronger when the doctor uses the pacemaker device to increase your heart rate, and you may feel some discomfort or a burning sensation when the energy is applied.
It is important to remain quiet, keep very still and avoid taking deep breaths. If you feel pain, ask your doctor or nurse to give you more medication
During the procedure, you will be asked to report any symptoms, answer questions or follow instructions given by your doctor.
How long does the procedure last?
The procedure may last 4 to 8 hours.