Catheter Ablation in India: Know the Facts!

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What Is Catheter Ablation?

Catheter ablation (ab-LA-shun) is a medical procedure used to treat some arrhythmias (ah-RITH-me-ahs). An arrhythmia is a problem with the speed or rhythm of the heartbeat.

During catheter ablation, a long, thin, flexible tube is put into a blood vessel in your arm, groin (upper thigh), or neck. This tube is called an ablation catheter. It’s then guided to your heart through the blood vessel. A special machine sends energy through the catheter to your heart. This energy finds and destroys small areas of heart tissue where abnormal heartbeats may cause an arrhythmia to start.

Overview

The heart’s electrical system controls the speed and rhythm of your heartbeat. With each heartbeat, an electrical signal spreads from the top of the heart to the bottom. As it travels, the electrical signal causes the heart to contract and pump blood.

The process repeats with each new heartbeat. A problem with any part of this process can cause an arrhythmia. (For more information about the heart’s electrical system, go to the Diseases and Conditions Index article on How the Heart Works.)

Catheter ablation is one of several treatments for arrhythmia. Your doctor may recommend it if:

• The medicines you take don’t control your arrhythmia.
• You can’t tolerate the medicines your doctor has prescribed for your arrhythmia.
• You have certain types of arrhythmia, such as Wolff-Parkinson-White syndrome.

Though few, catheter ablation has risks. These include bleeding, infection, and pain where the catheter is inserted. More serious problems include blood clots and puncture of the heart. Your doctor will explain the risks to you.

Cardiologists (doctors who specialize in treating people with heart problems) sometimes perform ablation through open-heart surgery. But this method isn’t as common as catheter ablation, which doesn’t require surgery to open the chest cavity.

Outlook

Catheter ablation alone doesn’t always restore a normal heart rate and rhythm. Other treatments may need to be used as well. Also, some people who have the procedure may need to have it done again. This can happen when the first procedure doesn’t fully correct the problem.

Other Names for Catheter Ablation

• Ablation
• Cardiac ablation
• Cardiac catheter ablation
• Radiofrequency ablation
• Catheter cryoblation

Who Needs Catheter Ablation?

Your doctor may recommend catheter ablation if:

• You have an arrhythmia that medicine can’t control.
• You can’t tolerate the medicines your doctor has prescribed for your arrhythmia.
• You have certain types of arrhythmia, such as Wolff-Parkinson-White syndrome or some forms of atrial fibrillation.
• You have abnormal electrical activity in your heart that raises your risk for ventricular fibrillation (a life-threatening arrhythmia) and sudden cardiac arrest.

What to Expect Before Catheter Ablation?

Before having catheter ablation, discuss with your doctor:

• How to prepare for the procedure, including limits on eating and drinking. You will likely need to stop eating and drinking by midnight before the procedure. Your doctor will give you specific instructions.
• Any medicines you’re taking, and whether you should stop taking them before the procedure.
• Whether you have diabetes, kidney disease, or other conditions that may require taking extra steps during or after the procedure to avoid complications.

Some people go home the same day as the procedure. Others need to stay overnight for 1 or more days. Driving after the procedure may not be safe. Your doctor will let you know if you need to arrange for someone to drive you home.

What To Expect During Catheter Ablation?

Catheter ablation is done in a hospital. Doctors who do this procedure have special training in cardiac electrophysiology (the electrical system of the heart) and ablation (destruction) of diseased heart tissue.

At the Start

Before the procedure, you’re given medicine through an intravenous (IV) line inserted in a vein in your arm. The medicine will help you relax. It may make you sleepy. You’re also connected to several machines that check your heart’s activity during the procedure.

Once you’re drowsy, your doctor numbs an area on your arm, groin (upper thigh), or neck. A needle is used to make a small hole through the skin into a blood vessel. Your doctor puts a tapered tube called a sheath through this hole.

Your doctor then puts a thin, flexible wire and an ablation catheter (a long, thin, flexible tube) through the sheath and into your blood vessel. The guide wire is threaded through your blood vessel to your heart. The wire helps your doctor place the catheter correctly.

Then, your doctor puts a special dye into the catheter. The dye makes the inside of your heart show up on special x-ray images called angiograms. The images help your doctor place the tip of the catheter in the correct spot in the heart.

During the Procedure

Electrodes at the end of the catheter are used to stimulate the heart and record its electrical activity. This helps your doctor learn where abnormal heartbeats are starting in your heart.

Your doctor aims the tip of the catheter at the small area of heart tissue where the abnormal heartbeats are starting. A special machine sends energy through the catheter to create a scar line, also called an ablation line. The types of energy used include radiofrequency (heat generated by electrodes), laser, or cryo- (very cold temperatures).

The animation below shows catheter ablation. Click the “start” button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.

The animation shows an ablation catheter inserted into the heart. This catheter is used to destroy, or ablate, a small part of the heart muscle that’s causing arrhythmias. The process allows the heart to return to its normal rhythm.

What You May Feel?

You may sleep on and off during the procedure. You generally will not feel anything except for:

• A burning sensation when the doctor injects medicine into the area where the catheter will be inserted
• Discomfort or burning in your chest when the energy is applied
• A faster heartbeat during studies of your heart’s electrical system

The procedure lasts 3 to 6 hours. When the procedure is done, your doctor will pull back the ablation catheter and take it out along with the sheath and guide wire.

The opening left in the blood vessel is closed and bandaged. Nurses apply pressure to this site to help prevent major bleeding and to help the site begin to heal.

What to Expect After Catheter Ablation

After the procedure, you’re moved to a special care unit where you lie still for 4 to 6 hours of recovery. Lying still prevents bleeding at the site where the catheter was inserted.

While you’re in the special care unit, you’re connected to special devices that measure your heart’s electrical activity and blood pressure. The nurses check these monitors continuously. Nurses also check to make sure that there’s no bleeding at the catheter insertion site.

Going Home

Your doctor determines whether you need to stay overnight in the hospital. Some people go home the same day. Others need to stay overnight for 1 or more days.

Before you go home, your doctor will tell you:

• Which medicines you need to take
• How much physical activity you can do
• How to care for the area where the catheter was inserted
• When to see the doctor again

Driving after the procedure may not be safe. Your doctor will let you know if you need to arrange for someone to drive you home.

Recovery and Recuperation

Recovery from catheter ablation is usually quick. You may feel stiff and achy from lying still for 4 to 6 hours after the procedure. In addition, a small bruise may form at the site where the ablation catheter was inserted. The area may feel sore or tender for about a week. Most people are able to return to normal activity in a few days.

Talk to your doctor about signs and symptoms to watch for. Let your doctor know if you have problems such as:

• A constant or large amount of bleeding at the catheter insertion site that you can’t stop with a small bandage
• Unusual pain, swelling, redness, or other signs of infection at or near the catheter insertion site
• Strong, rapid, or other irregular heartbeats
• Fainting

What Are the Risks of Catheter Ablation?

Though few, catheter ablation does have risks. Possible problems are:

• Bleeding, infection, and pain where the catheter was inserted.
• Damage to blood vessels. This complication is very rare. It’s caused by the catheter scraping or poking a hole in a blood vessel as it’s guided to the heart.
• Puncture of the heart.
• Damage to the heart’s electrical system. This may lead to the need for a permanent pacemaker. A pacemaker is a small device that’s placed under the skin of your chest or abdomen to help control abnormal heart rhythms.
• Blood clots, which could lead to stroke or other damage.
• Narrowing of the veins that carry blood from the lungs to the heart. This is called stenosis.

As with any heart procedure, complications can sometimes, although rarely, be fatal. The risk of complications is higher if you have diabetes or kidney disease. It also is higher if you’re 75 years old or older.

Key Points

• Catheter ablation is a medical procedure used to treat some cardiac arrhythmias (irregular heartbeats). It’s one of several treatments for arrhythmia.
• Your doctor may recommend catheter ablation:
  • To treat your arrhythmia if medicine doesn’t help or if you can’t tolerate the medicine.
  • If you have certain types of arrhythmia, such as Wolff-Parkinson-White syndrome or some forms of atrial fibrillation.
  • If you have abnormal electrical activity in your heart that increases your risk for ventricular fibrillation (a life-threatening arrhythmia) and sudden cardiac arrest.
• Catheter ablation alone doesn’t always restore a normal heart rhythm. Other treatments may be needed as well. Also, some people who have the procedure may need to have it done again. This can happen when the first procedure doesn’t fully correct the problem.
• Your doctor can tell you how to prepare for the procedure.
• Catheter ablation is done in a hospital. Doctors who do this procedure have special training in cardiac electrophysiology (the electrical system of the heart) and ablation (destruction) of diseased heart tissue.
• During the procedure, your doctor uses a long, thin, flexible tube called an ablation catheter to find the area where abnormal heartbeats are starting. Then, with the tip of the catheter, the doctor uses one of several energy forms to find and destroy this tiny area.
• The procedure lasts 3 to 6 hours.
• After the procedure, you will need to lie still for 4 to 6 hours. Some people are able to go home the same day. Others need to stay overnight for 1 or more days.
• Recovery is usually quick. Most people return to normal activity in a few days. Talk to your doctor about signs and symptoms to watch for. Let your doctor know if you have a large amount of bleeding at the catheter insertion site or pain, swelling, redness, or other signs of infection.
• Though few, catheter ablation does have risks. Some possible complications are bleeding, infection, and pain where the catheter was inserted. More serious problems are blood clots and puncture of the heart.

FAQ’s

• I’ve heard a lot about catheter ablation – how do I know if this treatment is right for me?
• Assessment by an electrophysiologist is the best way to be sure this is the most appropriate treatment for your particular condition. It is not typically the first line of treatment, but if you think you have atrial fibrillation it is an option to consider.

 

• How long does the procedure 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.

 

• Will I be awake? Will I feel pain?
• You will be made as comfortable as possible, but you will not be under general anesthesia. You will be in what is considered “twilight sleep” and you will be dozing off and on. You probably won’t remember much from the procedure.

 

• Are there any dietary restrictions?
• There are no dietary restrictions associated with your device. There may be dietary restrictions, however, associated with your heart condition. Be sure to follow your doctor’s advice with regard to sodium, fats and sugars.

 

• How long will I be at the hospital, and what limitations will I have?
• The procedure always requires an overnight stay. You will not be able to drive for 24 hours. You should also not lift, push or pull anything more than 10 pounds for 3 days following the procedure.

 

• How long will it take me to feel better?
• Many patients experience occasional episodes of atrial fibrillation during the first three months after left atrial catheter ablation even though they continue to take medications. This is because it may take three months for the scars to develop and the procedure to take full effect. But for most patients, this post-procedure atrial fibrillation will eventually go away.

 

• When will I know if the procedure worked? And when can I stop my medications?
• After three months, you will have a follow-up appointment, and we will reassess how well you have responded to the treatment. At that point, we will make decisions about continuing your blood thinners and heart rhythm-controlling medicines.

 

• Will I have to do the procedure more than once?
• A certain percentage of patients will need to come back for a second procedure. However, that won’t be determined until after the 3-month follow-up appointment to allow for sufficient healing time.

 

• What is the recovery like, and when can I return to normal activities?
• In general, you should avoid strenuous activity and heavy exercise for 10 days. You should also avoid lifting more than 10 pounds during this period of time.

 

• How do I prepare for the procedure?
• You may be asked to stop taking some medications including blood thinners prior to the procedure. Do not eat or drink anything after midnight the day before the procedure.

 

• What do I do on the day of the procedure? Can I bring a family member or friend?
• Yes, you may bring a family member or friend. You should bring a list of medications approved by your doctor (including prescription, over-the-counter medicines, vitamins, and supplements). Do not bring any valuables with you. Someone will call you one to two days before your procedure to tell you what time to arrive at the medical center.

 

• What should I do if I have questions before, during, or after my procedure?
• Kindly fill up our free consultation form or call us at +91-9370586696 with any queries. On the day of your procedure, your doctor and nurses will be bale to answer all your questions as well.

 

• How will I get an Indian Medical Visa?
• To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.