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Catheter Ablation
What is ablation?
This procedure, also known as catheter ablation, is minimally invasive. Other names for this procedure include cardiac, atrial or heart ablation. Ablate means to remove, burn or destroy. We intentionally create small scars on your heart during this procedure to interrupt the electrical signals causing abnormal heart rhythms (arrhythmias). This can restore your heart’s normal rhythm.
Types
We can perform a catheter ablation using heat (radiofrequency energy) or by freezing the tissue (cryoablation). Both are safe and effective procedures with equal success rates. While a catheter approach is more common, another option is surgical.
Surgery involves making little cuts to create scar tissue. We often choose this option if you already need a heart surgery, and we can perform both simultaneously (maze surgery). If we decide to perform it surgically instead of using a catheter, we may choose the mini maze. We can also combine the two (convergent procedure).
Who needs this procedure?
You may be suitable if your medication hasn’t been effective or caused significant side effects. We may also recommend this procedure if you have a high risk of complications due to arrhythmias.
We use this procedure to treat the following heart conditions:
Our specialist may perform additional tests to determine your suitability and learn more about how your heart condition affects you. These may include a blood test, CT or MRI scans and chest X-ray. We might recommend an echocardiogram, electrocardiogram or transoesophageal echocardiogram (TEE) as well.
How to prepare
You may need to stop taking certain medications, such as blood thinners, for a few days. The night before, you will need to stop eating and drinking. We recommend wearing comfortable clothes and not wearing jewellery on the day.
We will use a local anaesthetic and sedation, or general anaesthetic, to make you comfortable and avoid pain during the procedure. We will discuss your preference with you. Before we start, let us know if you have new questions or want further clarification on what will happen.
How is it performed?
Techniques vary depending on the condition. The procedure itself usually takes around one to two and a half hours. We pass thin, floppy wires (catheters) to your heart via the vein in the leg (femoral vein). The femoral vein acts like a motorway between the two.
The catheters record your heart’s electrical activity and emit electrical impulses to identify the abnormal tissue causing your arrhythmias. We might use a dye to see this area easier on our X-ray.
Once we have found the abnormal tissue, we form small scars using radiofrequency energy, or cryogenically using a cryoballoon. Here, we inflate the balloon at the problem area to deliver freezing energy. This part may be slightly uncomfortable if you are awake for the procedure.
After this, we will remove the catheters. Catheter removal can cause some bleeding, and you may have a small bruise after. You’ll need to rest for a few hours before going home. Some people need to stay overnight, but this depends on the heart condition we’re treating and other factors. Our specialist will discuss how long you can expect to stay in advance.
Recovery
You may experience some side effects of the procedure over the next two to three months, such as palpitations and further arrhythmias. This is common, and we refer to this as the blanking period. After this time, we can determine whether the procedure was a success. Our specialist will discuss this with you further before you have the procedure, so you know what to expect.
Avoid driving for 48 hours, working for a few days, and strenuous activity, such as heavy lifting, for two weeks. Many factors can influence your recovery, so you must listen to your doctor’s personalised recommendations.
Talk to our specialist if you are concerned about your symptoms after the procedure. They can reassure your concerns or run tests to confirm there are no other problems that we need to address.
Our specialist may suggest some lifestyle changes to help you maintain good heart health. These can include eating a healthy diet with less salt, exercising more where possible, and managing stress levels.
Risks
Temporary side effects include tiredness and minor pain, bruising or bleeding where we’ve inserted the catheter. Ablation procedures are generally very safe, and complications are rare. However, there are some risks to consider.
Risks vary depending on the procedure and can include:
- Damaged blood vessels
- Bleeding around the heart
- Infection at the insertion site
- Requiring emergency surgery
- Bruising and bleeding in the leg
- Slow heart rate and needing a pacemaker
- A small risk of having a stroke due to blood clots or a heart attack
Benefits
As this procedure is minimally invasive, involving no surgery, patients usually recover quickly, walking within a few hours. It is a highly successful procedure with over an 80% success rate. There is a 95% success rate after a second, if another procedure is required.
For many people, ablation means being free of taking medications and heart rhythm problems. As a result, you should experience a better quality of life. In some cases, it can be a life-saving procedure.
To learn more, read our detailed patient guide: What is cardiac ablation? Purpose, procedure and recovery.
Ablation FAQs
What is an ablation?
What is an ablation?
0:47
Dr Syed Ahsan
Video Description
Video Transcript
An ablation procedure involves delivering radio frequency energy within your heart to try and fix abnormal heart rhythm problems. Ablation techniques and duration times vary depending on the type of condition you have, but in most cases, this involves passing a thin floppy wire via the vein in your leg called the femoral vein, and that acts like a motorway, which runs from your leg all the way up to your heart.
By putting a small sheath into that vein, we can pass the wire into the heart, find the abnormal area, which needs treatment and deliver treatment at that point. It’s a very safe procedure with very small risks but most people have absolutely no problems.
What happens on the day of an ablation procedure?
What happens on the day of an ablation procedure?
1:17
Dr Syed Ahsan
Video Description
Should I have an ablation or go on medication first?
Should I have an ablation or go on medication first?
0:24
Dr Syed Ahsan
Video Description
How long does recovery take after ablation?
How long does recovery take after ablation?
0:42
Dr Syed Ahsan
Video Description
Can I still have symptoms after an ablation procedure
Can I still have symptoms after an ablation procedure
0:35
Dr Syed Ahsan
Video Description
How soon can I exercise after ablation?
How soon can I exercise after ablation?
0:44
Dr Syed Ahsan
Video Description
What is cryoballoon ablation?
What is cryoballoon ablation?
0:52
Dr Syed Ahsan
Video Description
How long until we know if an ablation was successful
How long until we know if an ablation was successful
0:16
Dr Syed Ahsan
Video Description
Do I still need to take medication after an ablation procedure?
Do I still need to take medication after an ablation procedure?
0:32
Dr Syed Ahsan
Video Description
Video Transcript
If you’ve had a successful ablation, we’re always keen to try and take you off the medications. Now, you may need to stay on the medications that prevent strokes, but certainly the medications that are controlling your heart rhythm, we, and I’m sure you are keen to come off them, and that’s often the way it happens. Occasionally, we may need to continue on some of those medications after your ablation, but we’ll discuss that with you and we can have a clear understanding of what needs to be done.
Do I need a general anaesthetic for an ablation procedure?
Do I need a general anaesthetic for an ablation procedure?
0:17
Dr Syed Ahsan
Video Description
In most patients, we do this procedure under a general anesthetic.
It’s more comfortable for you. We can use a camera during the procedure to help monitoring,
but we do do the procedure with just local anesthetic and sedation in some cases.
How successful is an ablation procedure?
How successful is an ablation procedure?
0:44
Dr Syed Ahsan
Video Description
Dr. Syed Ahsan, a Consultant Cardiologist at London Heart Clinic, emphasises that ablation for AF is a very successful treatment. Initial procedures achieve over 50% rhythm maintenance, with higher success rates in subsequent attempts. However, if you’ve had multiple ablations that have failed, a newer option called the convergent procedure may be right for you. Contact the London Heart Clinic to learn more about your treatment options.
Video Transcript
Ablation for AF is very successful and overall more than 50% of patients after the first procedure will maintain a regular rhythm. Obviously, you may need more procedures and the incremental success rate increases with each procedure that you have. If you have episodes of AF, which are intermittent…
What to expect after an ablation procedure?
What to expect after an ablation procedure?
0:30
Dr Syed Ahsan
Video Description
Dr Syed Ahsan lists some of the things that you can expect after an ablation procedure, including the blanking period during which you may still experience palpitations as inflammation settles down.
What is catheter ablation?
What is catheter ablation?
0:44
Dr Syed Ahsan
Video Description
Dr. Syed Ahsan, a Consultant Cardiologist at London Heart Clinic, explains what happens during a catheter ablation, a minimally invasive procedure for the treatment of atrial fibrillation (AF). Instead of surgery, small wires and balloons are passed through veins in the leg, which act like a motorway into the heart. This allows the delivery of high-frequency energy or freezing within the heart to prevent abnormal electrical signals that trigger AF and other rhythm issues. This procedure is effective, safe and efficient, and many people are able to go home the same day as their procedure.
What can I expect before and after my ablation procedure?
What can I expect before and after my ablation procedure?
0:42
Dr Syed Ahsan
Video Description
Dr Syed Ahsan lists some of the things that you can expect before and after your ablation procedure, including assessments by the specialist and nurse beforehand, and recovery afterward.
What happens during a catheter ablation procedure?
What happens during a catheter ablation procedure?
1:54
Dr Syed Ahsan
Video Description
Dr Syed Ahsan explains what happens during a catheter ablation procedure, including the passing of fine wires through the veins in your leg through to your heart. They then create a 3D image of the heart, and deliver the treatment to very specific areas.
What can I expect from a catheter ablation procedure?
What can I expect from a catheter ablation procedure?
0:19
Dr Syed Ahsan
Video Description
Dr. Syed Ahsan explains that most catheter ablations can be done as day procedures without surgery, and in most cases you will be up and walking within a few hours.
Video Transcript
Depending on the type of ablation procedure you have, this can often be done nowadays as a day case. The recovery after the procedure is normally very quick. And you don’t have any surgery, so you’ll be up and walking around normally within a few hours.
What is the difference between cryoablation and radiofrequency ablation?
What is the difference between cryoablation and radiofrequency ablation?
0:21
Dr Syed Ahsan
Video Description
Consultant Cardiologist for Bart’s Heart Centre Dr. Syed Ahsan explains that both cryoablation and radiofrequency have equal rates of success, and are both as safe as the other.
Video Transcript
Radiofrequency in cryoablation, which is freezing of the heart, have recently been compared for the treatment of atrial fibrillation, which is an irregular heart rhythm. The data that we have to date suggests that both techniques carry equal success rates, and are both as safe as each other.
What is the recovery time from catheter ablation?
What is the recovery time from catheter ablation?
0:23
Dr Syed Ahsan
Video Description
Dr Syed Ahsan explains that the recovery time from an ablation procedure is usually very quick, and you will be discharged the same day (and rarely the next day).
What are the success rates?
What are the success rates?
1:25
Dr. Syed Ahsan
Video Description
“Looking for more information about ablation success rates? Dr. Syed Ahsan lists the different success rates for SVT (supraventricular tachycardia), paroxysmal atrial fibrillation and persistent atrial fibrillation, stressing that they are unique to each individual.
The success rates for ablation for SVT is very high, explains Dr Syed Ahsan, Consultant Cardiologist. It is in the high 90’s in terms of percentage. For atrial fibrillation the success rates depend on the type of atrial fibrillation you have and whether you have any other conditions such as high blood pressure or diabetes.”
Video Transcript
All of the success rates for ablation for SVT or supraventricular tachycardia are very high, in the high 90s, in terms of percentage. So this is really a curative procedure and it’s now offered to patients as a first-line treatment even before medications because the success rate is so good….
What are the signs an ablation procedure was successful?
What are the signs an ablation procedure was successful?
0:48
Dr Syed Ahsan
Video Description
Dr Syed Ahsan lists some of the signs that an ablation procedure was successful, and explains that while you may experience further palpitations during the blanking period, this does not mean that your treatment was unsuccessful.
What are the risks of ablation?
What are the risks of ablation?
0:27
Dr. Syed Ahsan
Video Description
Dr. Syed Ahsan assures viewers of this short video that the chance of risks involved in ablation is very low, and in some rare cases patients experience bruising, tenderness, or needing a pacemaker.
What can ablation treat?
What can ablation treat?
0:21
Dr Syed Ahsan
Video Description
Wondering what an ablation can treat? Consultant Cardiologist Dr. Syed Ahsan lists these conditions, including SVT (supraventricular tachycardia), atrial fibrillation, atrial flutter, and ventricular arrhythmias.
Book an appointment
Breathlessness can feel uncomfortable and unsettling, but we’re here to help put you at ease.
Our specialist will discuss your treatment in depth so you understand its purpose and how it will work. We are happy to answer any questions to ensure you feel comfortable with our treatment plan.
Call London Heart Clinic on 0203 303 0325 to book an appointment.
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What our patients say
After suffering from a heart condition for a number of years I was very happy to meet Dr Ahsan, from the first consultation where he believed there was a solution I have now completed the surgery and had my final consultation with him today…
I am very grateful to have Dr Syed Ahsan as my consultant. Dr Ahsan always greets you warmly on each visit despite his busy workload. Dr Ahsan explains everything clearly and helps you to understand even the most complex medical terms…