The heart's electrical system creates the signals that tell your heart when to beat. Electrophysiology (EP) is a specialization of medicine that focuses on the electrical behavior of the heart. Electrophysiologists are trained to perform cardiac electrophysiology studies to diagnose heart rhythm problems, known as arrhythmias, as well as radiofrequency catheter ablation procedures to eliminate them.
The Electrophysiology Section at Ohio State’s Ross Heart Hospital consists of the largest group of electrophysiologists in central Ohio as well as more than 100 nursing staff members dedicated to the care of patients with heart rhythm problems. The Ross Heart Hospital is home to the largest electrophysiology program in Ohio and one of the top three in the nation utilizing physician experience coupled with advanced technology.
Radiofrequency catheter ablation is used to treat arrhythmias such as paroxysmal supraventricular tachycardia, atrial flutter and ventricular arrhythmias. If you have atrial fibrillation, read about catheter ablation of atrial fibrillation.
What is Radiofrequency Catheter Ablation?
Radiofrequency catheter ablation is a technique that delivers radiofrequency energy through the tip of the catheter that is positioned at the site of origin of an arrhythmia, or abnormal heart rhythm. The radiofrequency energy creates an irreversible lesion in the heart so to permanently eliminate your arrhythmia.
Why might you need Radiofrequency Catheter Ablation?
Radiofrequency catheter ablation can be used to permanently eliminate several types of arrhythmias, including:
If you are experiencing symptoms such as fainting, episodes of almost fainting, sensations of rapid heartbeats or excessively slow heart beats, your physician may recommend an Electrophysiology Study. Your electrophysiologist will make a diagnosis based on the results of your study. If you are found to have a heart beat that is too fast, you may be a candidate for radiofrequency catheter ablation and this procedure may be done at the same time as your electrophysiology study.
What to Expect During Catheter Ablation
Preparing for Your Procedure
You will be asked to not eat or drink anything other than water for a period of time before the test, often starting at midnight the night before your test. Your physician will give you specific instructions on which medicines, if any, you should stop taking before the test. If you are not given specific instructions, please take your medicines as you normally would.
On the day of your radiofrequency catheter ablation, a nurse will start an intravenous (IV) line. The IV line is placed so the doctors can give you medicine during the test if needed. Your nurse will also shave an area over your groin. This is where your doctor will put the tubes (catheters) and wires during your test.
Although you will be given a general time for your procedure, you may be taken at any time during the day. The time will depend on how many patients are scheduled, how long each test takes and if there are any emergencies.
During Your Procedure
Your procedure will be done by a doctor who is board-certified in electrophysiology (known as an electrophysiologist) who will be assisted by technicians and nursing staff who specialize in only electrophysiology procedures.
The EP Laboratory is an X-ray room with special equipment to monitor your heart rhythm. You will be given medicine to help you relax and to relieve any discomfort. The procedure is done while you are sedated to a comfortable state but you will not be under general anesthesia unless ordered by your doctor. You will be helped onto the X-ray table and the nurses will prepare you for the procedure by placing adhesive pads on your chest and legs. A large sterile sheet will be placed over you from your neck to your toes. Your electrophysiologist will then insert catheters (flexible tubes) into the blood vessel in the groin area. Local medicine is injected to eliminate the discomfort when placing the catheters.
Your electrophysiologist will position the catheters into the heart using X-rays to guide positioning of the catheters.
The initial part of the ablation procedure is to map and find the origin of your arrhythmia. This process may include the use of advanced mapping technology that allows 3D mapping of multiple heart chambers. Once the site of origin of your arrhythmia is found, the ablation lesion can be created using radiofrequency energy. The radiofrequency energy creates an irreversible lesion in your heart to permanently eliminate your arrhythmia.
Ohio State’s Ross Heart Hospital offers advanced ablation technology that includes use of large tip radiofrequency catheters, cooled-tip radiofrequency catheters, pulsed-energy radiofrequency ablation, cryo-ablation energy and ablation guided by Stereotaxis magnetic navigation. Radiofrequency ablation is often quite successful, with a success rate of about 96-98 percent.
After Your Procedure
When the procedure is over, the catheters and wires will be removed. Pressure will be placed over your blood vessels to stop any bleeding. To prevent bleeding, you will need to be in bed and have your leg straight for about 3-4 hours. You will be told when you may get up. If you need to use the bathroom during this time, please ask your nurse for help.
Your nurse will check the areas where the catheters were placed, your pulses and your blood pressure several times. You will be able to eat and drink after your procedure. Your doctor will decide when the IV will be stopped.