Catheter Ablation

A catheter ablation is a procedure that uses energy to remove small areas of heart tissue that cause abnormally fast heartbeats.

What is a catheter ablation?
Why do I need a catheter ablation?
What are the risks of having a catheter ablation?
How do I prepare for a catheter ablation?
What happens during a catheter ablation?
What happens after a catheter ablation?

What is a catheter ablation?

Catheter ablation is a treatment that uses energy (radiofrequency or pulse field technology) to remove small areas of heart tissue that cause abnormally fast heartbeats, called tachyarrhythmias.

Why do I need a catheter ablation?

Your doctor may recommend a catheter ablation as treatment for:

  • Arrhythmia - when your heart beats in an irregular way and may not pump blood effectively (you may feel breathless, weak and dizzy or feel your heart is racing in the form of palpitationsand thumping)
  • Supraventricular Tachycardia (SVT) – when your fast heart beats are triggered by an area above the ventricles, in the right and left atrium of your heart such as AV Nodal Reentrant Tachycardia (AVNRT), Atrial Tachycardia, Atrial Fibrillation, Atrial Flutter or Wolf-Parkinson White Syndrome.
  • Ventricular Tachycardia (VT) – these occur from fast heart beats originating from the right or left ventricle. These are generally considered more dangerous arrhythmias if you have had a heart attack or have heart failure.

What are the risks of having a catheter ablation?

While serious risks are unlikely, there are some risks associated with a catheter ablation procedure. 

The most common risk for this procedure is bruising or swelling at the puncture site in the leg. 

Less common complications are:

  • Abnormal heart rhythms, called arrhythmias
  • Inflammation of the heart lining called pericarditis
  • Major bleeding or bruising at the puncture site
  • Infection
  • Damaged heart muscle, heart valves or blood vessels that may require surgery
  • Blood clot in the lung or legs
  • Stroke or heart attack
  • Heart block - needing a pacemeaker
  • Death from this procedure is rare

Your doctor will have a more detailed discussion about risks before you agree to the surgery. As there are many different forms of catheter ablation, it’s important you take the time to discuss your procedure with your doctor and raise any questions or concerns. Your doctor will ask you to sign a consent form to agree to the procedure

How do I prepare for a catheter ablation?

Before your catheter ablation procedure you will be asked to:

  • Do not eat eating or drink for 6 hours before your procedure
  • Ask your doctor about taking your usual medication, particularly blood thinning medication. If you take SGLT2 medicine for diabetes, you will need to stop taking them at least 3 days before your surgery. Read our Patient Information Guide on SGLT2 inhibitors for diabetes.
  • Remove any jewellery that you wear every day and put on on a hospital gown

What happens during a catheter ablation?

Your catheter ablation procedure takes place in the Electrophysiology Lab, which looks like an operating theatre. You will be taken to the procedure room on a trolley and be asked to lie on a procedure table. You will be awake during your procedure but before it begins your doctor will give you sedation (Midazolam/Fentanyl) to help you relax. This is given through a cannula in your arm. During the procedure:

  • Your groin (the top of your leg) area is shaved
  • A local anaesthetic numbs the area
  • Catheters are inserted into the groin via a tube (sheath), gently passed through veins until they reach your heart
  • An X-ray machine guides the catheters to your heart
  • Your doctor uses electrical impulses to make your heart beat at different speeds
  • You may need medication or a brief shock to control your heart beat during the procedure
  • Your heart beats are recorded using sophisticated analysis equipment.

Your doctor will determine the exact location of your arrhythmia using a technique called ‘mapping’. The catheter tip is placed at this location to produce a pulse of energy, which will scar tiny areas of heart tissue that are responsible for the abnormal heart rhythm. This will destroy the source of the abnormal electrical activity and correct the abnormal heartbeats.

The catheter ablation procedure can take up to 4 or more hours. Make sure you let your doctor know if you experience any discomfort or pressure in your chest at any time during the procedure.

What happens after a catheter ablation?

After your catheter ablation is finished, your doctor will remove the catheters and apply pressure, followed by a dressing. You’ll be watched closely in a recovery area, and depending on how you feel, you might need to rest in bed for a while.

Most people can return to their normal activities in a few days. For two or three days after your catheter ablation you may feel tired, sore in your chest and leg (where the catheters were placed) or experience fast, irregular or skipped heartbeats. Your doctor may change your usual heart medication.