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.

Getting Ready

The week before your ablation:

• Ask your caregiver if you need to stop taking any prescribed or over-the-counter (OTC) medicine before your ablation. Medicines you may need to stop taking include certain heart medicines, diabetic medicines, aspirin, ibuprofen, or prescription blood thinners. Do not stop any of your medications without asking your caregiver first. Tell your caregiver about any vitamins, supplements, or herbal medicine that you use, as they may change the way other medicines work.
  
  
• Tell your caregiver if you have ever had bleeding problems. Also, tell your caregivers if you are or think you might be pregnant.
  
  
• You may need to have tests done before the procedure, such as blood tests or a chest x-ray. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test
  
  
• Ask a family member or friend to stay with you after the ablation. They can help take care of you if you need to lie flat in bed after the procedure. You will also need someone to drive you home when you leave the hospital after your ablation.

The night before your ablation:

• Your stomach needs to be completely empty (no food or water) for 6 to 12 hours before the ablation. Ask caregivers about directions for eating and drinking.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your procedure. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the procedure. You may need to check your blood sugar more often before and after having your procedure.

The day of your ablation:

• Write down the correct date, time, and location of your procedure.
  
  
• Medicines: Ask your caregiver before taking any medicine on the day of your ablation. These medicines include insulin, diabetic pills, high blood pressure pills, and heart pills. If you take pills on the day of your ablation, take them with very little water, and write down the time they were taken. Bring a list of your medicines or the pill bottles with you to the hospital. Tell your caregiver about any herbal supplements or over-the-counter medicines you have taken recently. Tell your caregiver if you are allergic to medicines, tape, or anything else.
  
  
• Bathing: Take a complete bath or shower and wash your hair before your ablation. You may not be able to fully bathe until a few days after the procedure. Remove any nail polish.
  
  
• Contacts, dentures, and hearing aids: Do not wear contact lenses the day of your ablation. You may wear your glasses. If you regularly wear dentures or hearing aids, wear them to the hospital. You should be able to keep them in during the ablation. Your caregivers may need for you to hear and talk to them clearly during the procedure.

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.

Treatment

What will happen:

• You will be asked to remove all clothing and change into a hospital gown. Go to the bathroom before the test so that you will be comfortable. Caregivers may ask you to remove any jewelry, hairpins, glasses, and dental plates. You may be hooked up to one or more machines to monitor your heart, blood pressure, and breathing. You may have one or more IV tubes placed in your vein which are used to give you medicine or liquids. You may receive medicine to help you relax or make you drowsy. You may get medicine called local anesthesia that will numb the area where the catheter will go in.
  
  
• 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. One or more catheters will be put into your blood vessel, usually in your neck or groin. X-rays will be taken to help your doctor guide these catheters through your blood vessels to your heart.

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 for the first one to two hours after your ablation. They will also check the blood flow in the arm or leg 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. This catheter drains urine from your bladder into a special collection bag. 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 have 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.

Waiting room:

This is a room where your family and friends can wait until you are ready for visitors after the ablation. If your family leaves the hospital, ask them to leave a phone number where they can be reached.

Contact a caregiver if

• You cannot be at your appointment on time.
  
  
• You have questions or concerns about your procedure.
  
  
• You have a fever. Your procedure may need to be done later when you are well.
  
  
• You took any medicine that you were told to stop, such as heart medicine. Your procedure may need to be done later, after you have stopped taking the medicine for a period of time.
  
  
• The problems for which you are having the ablation get worse.

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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 (Precare)