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What to Expect During Catheter Ablation

Your catheter ablation procedure will be done by an electrophysiologist in the electrophysiology (EP) lab . You will be hooked up for intravenous delivery of medications and fluids, and will receive medication for either conscious sedation, which puts you in a fog, or general anesthesia, which puts you to sleep. General anesthesia may be reserved for high-risk patients, such as those with sleep apnea or at risk for airway obstruction or pulmonary edema.1

You'll also be hooked up to a variety of monitors and equipment, which may include:

  • Pacing device, which will speed up the heart
  • Electrocardiogram (ECG) Blood pressure monitor
  • Mapping system, which helps the doctor locate the source of irregular electrical impulses
  • Ablation machine to deliver radiofrequency, cryo, or laser energy for creating scar tissue
  • Fluoroscopy X-ray machine, which helps the doctor monitor the catheters
  • Intracardiac ultrasound, also called intracardiac echocardiogram (ICE), to help the doctor locate structures of the heart and gain access to the left atrium, and to determine where to place the catheters and how much energy to use for ablation (important in preventing pulmonary vein stenosis and other complications).

Once you're hooked up to all the equipment, and are drowsy or asleep, the doctor inserts the catheters into large veins in the groin, neck, or arm. They are directed toward the right atrium, and a needle carries the catheters through the septum, the wall between the left and right atrium, and into the left atrium.

The pacing device speeds up the heart by sending electrical impulses to it. When the source of your irregular heartbeat is located, the doctor will use the catheter to apply energy from the ablation machine to produce a scar that blocks electrical impulses from the pulmonary veins and other areas of the left atrium, shutting down the abnormal rhythms and preventing afib.

What should you expect to feel? When the doctor injects medication, you may feel a burning sensation, and may also feel burning or discomfort when the energy is applied. You may also feel your heart speed up or pulse when the pacing device increases the heart rate.

When the procedure is complete, the doctor will check the heart's electrical signals and ensure that the heart rhythm is correct. As you might guess, with so much equipment to hook up, this overall procedure can last for three to eight hours, or more.

To learn what to expect during recovery, see What to Expect After Catheter Ablation.

1 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up, http://www.hrsonline.org/News/Media/press-releases/CSAblation.cfm, Heart Rhythm Society, Copyright, 2007.

Last Modified 9/6/2011

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