Radio Frequency Ablation

Your doctor will first do an electrophysiology (EP) study to observe the electrical activity in your heart. This will show him what causes your tachycardia, which is an abnormally fast heart rhythm.

Once your doctor has found where the problem is, he will begin radio frequency (RF) ablation. It uses radio frequency energy to destroy the electrical path in your heart muscle that is causing your tachycardia.

Who needs this procedure?
Your doctor may recommend a radio frequency ablation for you because you have a fast heart rate (tachycardia).

Before the procedure
You will not be allowed to eat or drink anything the night before, and you should be prepared to spend one night in the hospital. You will be required to sign a permit, which explains the procedure and its risks.

In preparation for the RF ablation, you will receive medication to help you relax. If you are a diabetic, talk to your doctor before the procedure. He may need to adjust your medication. If you have a dye or shellfish allergy, inform your doctor and the electrophysiology lab staff so they can take special precautions to prevent a reaction.

During the procedure
This procedure is done in the electrophysiology lab, which is a large room with a lot of equipment. You will receive a medication intravenously (directly into your bloodstream) during the procedure. Your heart will be monitored continuously throughout the test, and you will have an automatic blood pressure cuff placed on your arm to monitor your blood pressure.

The doctor will thread catheters (electrical wires) to your heart through a vein (blood vessel) in your neck or groin. After the catheters are in place, the physician will pace (stimulate) the heart to start up your tachycardia. You may experience symptoms similar to those you are used to during a normal tachycardia, though they may be less severe since you are laying flat. It is important to talk to the staff during the procedure if you experience any symptoms.
Sometimes the physician may give you intravenous medications to help speed up your heart rate. This medication may make you feel anxious, warm and like your heart is pounding in your chest. Once the medication stops, your heart rate will return to normal and the symptoms will go away in 5-10 minutes.

When the abnormal pathway is located, radio frequency energy will be applied to it in order to destroy it. This will prevent the tachycardia in the future. The ablation procedure is usually not painful, but you may feel discomfort at the catheter insertion site or become tired from lying for such a long period of time. Some patients feel mild discomfort in their chest during the application of the radio frequency energy. It is important to remain still during the procedure. If you become uncomfortable, tell the staff so they can help you find a comfortable position.

After your pathway has been successfully ablated (destroyed), the catheters are removed. Pressure will be placed on the location where the catheters were inserted for 5-20 minutes. You will then move to a holding area or your room.

After the procedure
You will need to lie in bed keeping the leg where the catheters were inserted completely straight for four hours or more. If your back gets tired during this period, you may bend the unaffected side. You will be allowed to eat and drink. Your vital signs and catheter insertion site will be checked frequently at first to make sure there is no swelling or bleeding. If you see any bleeding or swelling, place your hand over the site and notify the staff immediately.

Once you return home, you may resume normal activity on a limited basis. You should not drive for 24 hours. You should not lift objects that are heavier than 10 pounds. If you received sedation (medications that made you sleep) during the procedure, we ask that you do not operate heavy machinery for 48 hours.

If you experience any bleeding or swelling after the procedure, place pressure on the site with your hand or have someone else apply pressure to the site for five minutes. If the swelling increases or bleeding does not stop, notify your physician. After the procedure, the site may be tender for a couple of days. If you notice any large amounts of swelling or red streaks from the site or on the affected leg, notify your physician.

What causes a fast heart rate?

A fast heart rate can be caused for different reasons including:

  • Supraventricular tachycardia , which is a series of rapid heart beats in the upper chambers of the heart;
  • Atrial flutter , which causes the upper heart chambers (atria) to beat much faster than the lower heart chambers (ventricle);
  • Wolff-Parkinson-White which is an extra pathway between an upper and lower heart chamber;
  • Atrial fibrillation, which causes the atria to quiver instead of beating normally;
  • Atrial tachycardia, which is a continuous irregular and too fast heartbeat in the upper chamber; and
  • Ventricular tachycardia, where the upper heart chambers (ventricles) cause a too rapid heart beat.