Cardiac Ablation

WHAT YOU SHOULD KNOW:

• Your heart has a special electrical system built into it that controls your heart rhythm. Sometimes there is a problem with this electrical system in the heart muscle. This problem may cause an arrhythmia (ah-RITH-mee-ah), or abnormal heart rhythm. If medicine does not correct the problem, or if you do not wish to take medicines long-term, you may need a cardiac ablation (ab-LAY-shun). An ablation may also be called a catheter ablation, or a radiofrequency ablation.
  
  
• An ablation procedure is usually done at the same time as an electrophysiology study. This test is used to "map out" the electrical pathways in your heart that control your heart rhythm. This test helps your doctor find the exact spot where the ablation needs to be done. During an ablation, energy is sent through a special catheter to the area of your heart that has the electrical problem. This energy causes a tiny area of the heart muscle to scar, stopping the electrical problem and allowing your heart to beat regularly. Ask your caregiver for more information about your heart problem, and tests and treatments that may be done for it.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• Risks of having a cardiac ablation are rare, but include bleeding too much after the procedure. Rarely, the catheter may cause a problem with your blood vessel that would take surgery to fix. The catheter may cause bleeding around your heart. You may have heart rhythm problems. Blood clots could go to your lungs or brain and cause a stroke. The clots could also go to your arm or leg, stopping blood flow. Caregivers will watch you closely for these problems.
  
  
• If you do not have an ablation, your health condition could get worse. Some people have heart rhythms that can be life threatening if not treated. Call your caregiver if you are worried or have questions about your medicine or care.

WHILE YOU ARE HERE:

Before your ablation:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Call button: You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Circulation checks: The pulses (heartbeat) in your wrists, feet, or ankles may be checked to make sure you have good blood flow. Caregivers may put an "X" over the spots on your legs and feet where the pulse is the strongest. Caregivers may also take a blood pressure reading in both arms or both legs.
  
  
• Echocardiogram:
  
  
  • This test is also called an echo. It is a type of ultrasound, using sound waves to show pictures of the size and shape of your heart. An echo also looks at how your heart moves when it is beating. These pictures are seen on a TV-like screen.
    
    
  • This test is done while lying down on your back. Clear jelly will be squirted on your chest to help the ultrasound sensor slide easily. The sensor will be rubbed across your chest to see your heart from different angles. You may hear a whooshing noise, which is the sound of your blood flow. Caregivers may ask you to pedal a bike during the test (exercise echo) or you may get medicine before the test to increase blood flow to your heart muscle (stress echo). This test can tell how well your heart is pumping. An echo can also find problems, such as fluid around the heart or problems with your heart valves.
  
  
• Foley catheter: A Foley catheter is a tube that is put into your bladder to drain your urine into a bag. The bladder is an organ where urine is kept. Keep the bag of urine well below your waist. Lifting the urine bag higher will make the urine flow back into your bladder, which can cause an infection. Avoid pulling on the catheter because this may cause pain and bleeding, and the catheter may come out. Do not allow the catheter tubing to kink because this will block the flow of urine.
  
  
• Heart monitor: This is also called an ECG. Sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen. This shows caregivers a tracing of the electrical activity of your heart.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.
  
  
• 12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.
  
  
• Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.
  
  
• Pre-procedure medicines: You may receive the following types of medicines before or during the procedure:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Sedative: A sedative medicine may be given to help you stay calm and relaxed.
  
  
• Pre-procedure care: You will be asked to remove all clothing and change into a hospital gown. Go to the bathroom before the procedure so that you will be comfortable. Caregivers may ask you to remove any jewelry, hairpins, glasses, and dental plates.

During your ablation:

• You will lie on a movable x-ray bed. Lead aprons may be placed over your neck or body to protect you from x-rays. A caregiver will use soap to clean the skin over the blood vessels that will be used during the procedure. This soap may make your skin yellow, but it will be cleaned off later. The skin may be shaved to see the area better. Sterile (germ-free) sheets will be put over you to keep the area clean. You may get medicine called local anesthesia that will numb the area where the ablation catheter will go in. You may also be given medicine in your IV to help you relax.
  
  
• One or more catheters will be put into a blood vessel, which is usually in your neck or groin. You may feel pressure or discomfort when a catheter is first put into the skin. X-rays will be taken to help your doctor guide these catheters through your blood vessels to your heart. It is very important that you lie still while the x-rays are taken so that caregivers can get good pictures.

After your ablation:

• When the ablation is over, the catheter will be taken out of your blood vessel. Firm pressure will be put over where the catheter went into your skin. This pressure may be held for at least 10 to 20 minutes. This allows the vessel to stop bleeding and seal over (clot). After pressure is held, you may have a tight pressure bandage and a sandbag placed over the puncture site. You will be able to eat and drink after caregivers know that the catheter site is sealed over and that your stomach is feeling OK. A collagen plug, stitches, or another device may be used to close a blood vessel.
  
  
• Caregivers will check your vital signs (blood pressure, heartbeat, and breathing) often after your ablation. They will also check the blood flow in your arm or leg on the side that was used for the ablation. You may need lie flat and keep your arm or leg straight for several hours after your ablation. Follow your caregiver's instructions carefully. Moving too soon after an ablation may cause serious problems. Do not raise the head or foot of your bed or get out of bed until your caregiver says it is OK. Let your caregiver know if lying flat is uncomfortable for you.
  
  
• You must use a bedpan or a urinal until you are able to get out of bed and go to the bathroom. If you are unable to use a bedpan or a urinal, a foley catheter may be placed in your bladder. Have a friend or family member stay with you until you are allowed to sit up and move around in bed. They can help you eat and drink during the time that you need to lie flat. When you are allowed out of bed, get up slowly. If you ever feel weak or dizzy, sit or lie down right away. Then call your caregiver.
  
  
• Caregivers will watch you closely for problems that can happen after an ablation. Tell your caregiver if:
  
  
  • You have chest pain, pressure, or tightness.
    
    
  • Your leg or arm feels unusually hot or cold, or turns a different color. Tell caregivers if your leg or arm hurts, or feels tingly or numb.
    
    
  • You feel swelling or wetness at the puncture site.
    
    
  • You have pain in your back, thigh or groin.
    
    
  • You feel nauseated (sick to your stomach) or start to sweat a lot.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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