Is it time to see a heart rhythm specialist?
If you feel like your heart is skipping a beat or fluttering in your chest, it might be an irregular heartbeat. A problem with your heart’s rhythm is called an arrhythmia (uh-RITH-mee-uh). You’re not alone. Millions of Americans are diagnosed with these kinds of heart rhythms. If medications do not help you, your doctor may suggest a catheter ablation (KATH-i-tur ah-BLAY-shun) procedure to treat your heart arrhythmia. There are different types of heart arrythmias and different kinds of catheter ablation. Here’s what you should know.
Heart arrhythmias are caused by a problem with the electrical signals in your heart.
On average, a healthy heart beats about 60 to 100 times a minute when at rest. If you have an arrhythmia, you might have a slower, faster or irregular heart rate.
Arrhythmias may happen in different parts of the heart, including the upper chambers of the heart, called the atria (ay-TREE-uh), or the lower chambers of the heart, called ventricles (VEN-tri-kulls).
Supraventricular (soo-prah-ven-TRI-kyuh-lar) arrhythmiasstart in the atria or the opening to the lower chambers of the heart.
Ventricular arrhythmias start in your heart’s ventricles, or the two lower chambers. These arrhythmias can be very dangerous and usually require medical care right away.
Your doctor may try medications to treat VT. These medications are called anti-arrhythmics. They can be given in a pill form or by a needle in your arm that slowly drips the medicine into your body. Other medicines can also be used, alone or with anti-arrhythmics. Calcium channel blockers and beta blockers are two commonly used drugs for VT. These drugs slow the heart rate and reduce blood pressure.
VT can be treated with medication, but there are some reasons why a ventricular ablation is right for you. You will talk to an electrophysiologist (eh-lek-tro-fi-zee-AHLL-uh-juhst), who has an expertise in understanding your heart’s electrical signals. Before recommending ablation, the physician will check:
Your physician may also take into consideration your age.
If you have a device that sends electrical signals to your heart to get it to beat correctly, called an implantable cardioverter-defibrillator, ablation can reduce the number of times this device needs to send signals to your heart to get it to beat correctly.
The ablation procedure typically has a higher success rate than medication alone, which means there is less risk of symptoms returning. There is a low risk of complications with this procedure, as well as a quick recovery time.
Treatment for VT involves managing any diseases that causes the condition, as well as the symptoms of VT. Common treatments for ventricular tachycardia include:
One of the most common non-invasive treatments for VT is called a catheter ablation (KATH-i-tur ah-BLAY-shun). A catheter is a thin flexible tube. It travels through a blood vessel up to your heart. The procedure uses hot or cold energy to create scars in your heart tissue where the arrhythmia is occurring. The scars help block certain electrical impulses and prevent irregular rhythms. The scars only destroy tissue involved with the targeted heart patterns, and they don’t cause any lasting pain.
In most cases, catheter ablations are done in an electrophysiology lab in a hospital, and it can take approximately one to three hours for the procedure. Sometimes it may take longer.
Norton Heart & Vascular Institute has two state-of-the-art electrophysiology labs where catheter ablations are performed located in Norton Audubon Hospital and Norton Hospital. We use 3D imaging to map your heart and identify the spot of tissue that’s causing the irregular heartbeat. Then we complete minimally invasive ablation procedures to treat the issue.
Your health care provider will go over what you need to do before a catheter ablation. Always follow your provider’s guidance and do not stop or start taking medications unless you are told to do so. You may be asked to stop blood-thinning medications like aspirin or warfarin. You will also be asked to stop eating and drinking for several hours before your procedure. Your provider will give you exact instructions.
Before the procedure, arrange for a trusted friend or family member to take you home after the procedure.
A nurse will help get you ready for an ablation by putting an IV line into your arm. You can receive medicine through the IV line, including drugs to make you comfortable and keep you from feeling any pain (this is also called anesthesia – an-uhs-THEE-zyuh). You may be awake during the procedure but you’ll be sedated and you will not feel pain.
Your cardiologist will:
You will stay in the hospital for several hours after the procedure. Your physician may have you stay the night.
Many patients wonder if catheter ablation hurts. Most people say catheter ablation is mildly uncomfortable but the discomfort doesn’t last long. Some patients also have little or no discomfort from the ablation at all. The place where the catheter went into your vein may be sore and have a bruise. The opening for the catheter is very small and should heal quickly.
Your heart will heal and recover in time. For a little while – usually a few weeks – you may still feel abnormal heart rhythms and experience more tiredness than you are used to. This is normal. Tell your doctor if you have any questions or concerns after an ablation.
You should begin to notice a decrease in abnormal heartbeats after the ablation. You will need to visit the doctor for some follow-ups to be sure you are recovering. Most people see improvements in their quality of life after VT ablation, including feeling less tired or needing fewer signals from their implantable cardioverter-defibrillator. If your abnormal heart rhythm does not stop or stops and starts again, you may need a repeat procedure or alternate treatment.
Before the procedure, a doctor will find out exactly where the arrhythmia is. The electrophysiologist will do an electrophysiology (EP) study to know where the tissue is in your heart that is causing the arrhythmia. Once the area of the arrhythmia is known, the physician will create a more precise electrical map of your heart with a 3D mapping system. This map gives an electrical view of your heart and tells them where to position the ablation catheters to send heat or cold energy to the targeted areas. Norton Healthcare is one of the only health care systems in the area that has this advanced 3D mapping technology.
During the VT ablation, sensors on the tip of the catheter send electrical impulses and record the heart’s electricity. Your health care team will use this information to determine the best place to apply the VT ablation treatment.
There are two types of ablation:
Either type of ablation can be done from inside or outside the heart. Sometimes, treatment is done at both locations.
Some people wonder if a catheter ablation hurts. Most patients say the discomfort is mild and does not last long. Some patients also have little or no discomfort from the ablation at all. The site where the catheter went into your vein may be sore and have a bruise. The spot is very small and should heal quickly.
Catheter ablation can take two to four hours to complete. After the procedure, you move to a recovery room and stay there for several hours. A nurse monitors your condition while you recover. You may need to stay at the hospital overnight.
When it’s time to go home, you’ll receive detailed instructions about at-home care. Your doctor may prescribe aspirin or other blood-thinning medication to help prevent blood clots. You may take this medicine for several months or longer after the procedure, depending upon your unique history.
As your heart tissue heals and recovers, you may continue to feel abnormal heart rhythms for a few weeks and experience more tiredness than you are used to. This is normal. You should alert your doctor if you have any questions or concerns about anything you’re feeling after an ablation procedure.
The benefits of catheter ablation include:
Possible risks include:
Your doctor will talk to you about all these issues, as well as any concerns or questions you have.
In most cases, catheter ablations are done in an electrophysiology lab at a hospital, and it can take approximately one to three hours for the procedure. Sometimes it may take longer.
You may be a candidate if you:
After an ablation, if you have any of the following symptoms, call your doctor immediately.
You should call your health care provider if you experience:
Norton Heart & Vascular Institute offers advanced care at all of our adult-service hospitals to save hearts and lives.
Norton Heart & Vascular Institute offers patient resources to support you and your family, including free classes for people of all ages who want to improve cardiovascular health or are living with a heart condition.