Catheter ablation

Catheter ablation is an invasive procedure performed to treat symptoms caused by various forms of arrhythmia, including atrial fibrillation, atrial flutter, SVT and accessory pathways, which have not been controlled by medical therapy or where the latter has not been tolerated due to side effects.

The procedure is carried out under sedation or general anaesthesia. It initially involves passing thin catheters, inserted in the femoral vein at the top of the leg, to access the right atrium of the heart under X-ray guidance. An electrophysiological study is performed to identify the origin of the arrhythmia.

In some patients, depending on the cause of the arrhythmia, the ablation will take place on the right side of the heart. Certain patients may require access to the left atrium and pulmonary veins such as treating atrial fibrillation. In this scenario, a transoesophageal echocardiogram may be required to exclude clots and aid crossing the interatrial septum. Radiofrequency energy is then transmitted to specific targets identified within the heart. This creates heat which destroys the affected area and aims to block abnormal electrical activity to treat the underlying condition.

This is an invasive procedure that carries a small degree of risk, including stroke, tamponade (puncture of the heart), femoral blood vessel damage, nerve damage, atrio-oesophageal fistula or need for pacemaker insertion. The risks and benefits would be discuss with you in detail by your cardiac specialist.