What is cardiac ablation?
Electrical impulses trigger every beat of your heart. This impulse starts in a node within the right atrium and then travels through the rest of your heart.
But for some people that impulse starts traveling on the wrong pathway. This can cause heart rhythm problems such as arrhythmia, otherwise known as palpitations.
Ablation treats many rhythm problems, including atrial fibrillation -- a "fluttering" of the upper chambers -- and ventricular tachycardia, a rapid heartbeat in the lower chambers that is potentially life threatening.
Medication helps treat arrhythmia, but if medications aren't working, there are three major approaches that may help:
- Catheter ablation. An electrophysiologist creates tiny scars in a few of the cells of your heart. These scarred cells create a "roadblock" for the electricity in your heart, forcing the impulses to travel on the right path. This is the least invasive of these procedures.
- Maze procedure. This open-heart surgery uses an energy source to scar the tissue (radiofrequency ablation). It is typically combined with other heart surgery.
- Mini maze procedure. This minimally invasive surgical ablation uses an energy source to scar the tissue. It doesn't require opening the chest, so you will have a shorter recovery time. It is less invasive than maze surgery and is slightly more invasive than catheter ablation.
Having both the electrophysiologist and the surgeon collaborate in the operating suite has led to the latest trend, the hybrid ablation procedure, which incorporates both catheter ablation and a mini maze procedure in a single operation.
How is an ablation done?
Catheter ablations take place in one of the electrophysiology labs at Lee Health.
Patients remain awake during this procedure. We will give you medication to relax and then make a small incision in your groin area. Our experts then insert thin tubes called catheters into this incision.
With the help of x-ray images, the catheters thread up to your heart. Your electrophysiologist uses the catheters to detect the faulty electrical pathways. Electrodes on the end of the catheter create tiny scars on the wall of your heart.
Catheter ablations typically take from 3-6 hours. After your ablation, you will wait several hours in the recovery area.
Most patients who have ablation procedures go home the same day, while some patients need to stay overnight in the hospital.
Maze and Mini Maze Procedures
Mini maze ablations are similar to the maze ablation, except that the surgeon reaches the heart through small incisions on each side of the chest and does not need to stop the heart.
You will receive medication through an IV to sedate you, and then the surgeon accesses the heart by making three small incisions between the ribs to insert a tiny camera and video-guided instruments.
The surgeon uses an energy source to make precise scars, or ablations, on the heart to block the irregular electrical impulses and removes or closes off the left atrial appendage where stroke-causing blood clots often form.
The mini maze procedure takes just a few hours and features a shorter recovery time and hospital stay.
Even with minimally invasive ablation procedures, there are several risks that you should know about:
- Bleeding at site of incision
- Puncture of the heart
- Damage to blood vessels
- Blood clots
- Worsened arrhythmia symptoms
- Heart tissue inflammation (pericarditis)
- Collapsed lung from deflating the lung in surgery, which is correctable with a chest tube (mini maze and maze procedures)
Technology and expertise
Lee Health has two fully equipped electrophysiology labs for ablation procedures and two dedicated implant room for device implants. Nurses and technicians here work exclusively on heart rhythm disorders.