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. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. 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 and you may have heart rhythm problems. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• 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: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• 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 a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.
  
  
• Foley catheter: This is a tube caregivers put into your bladder to drain your urine into a bag. Keep the bag below your waist. This will help prevent infection and other problems caused by urine flowing back into your bladder. Do not pull on the catheter, because this may cause pain and bleeding, and the catheter could come out. Keep the catheter tubing free of kinks so your urine will flow into the bag. Caregivers will remove the catheter as soon as possible, to help prevent infection.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Pre-procedure medicines: You may receive the following types of medicines before or during the procedure:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Sedative: This medicine is 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.

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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.

Learn more about Cardiac Ablation (Inpatient Care)