Cardiac ablation : Procedure, Risks, Prepare, Cost, Recovery process

Cardiac ablation refers to the procedure used by cardiologists to correct arrhythmias. Arrhythmias refer to the heart rhythm problems that cause severe complications to people. The procedure works by scarring or destroying the heart tissue triggering or sustaining an abnormal heart rhythm. The procedure is also used to prevent abnormal electrical signals from your heart. So, it can successfully stop abnormal heart rhythms. During the procedure, your cardiologist uses catheters (a long, thin, and flexible tube) through your artery or veins in the groin region into the heart. Then, the cardiologists deliver heat or cold energy to modify the heart tissue causing the problem. Cardiac ablation is also performed during open-heart surgery. But, the use of catheters makes it the least invasive procedure with a short recovery time.

Need For Cardiac Ablation Procedure

In normal cases, when your heart beats, the electrical impulses triggering the contraction follow a precise pathway through the heart. The interruptions in the electrical impulses cause arrhythmia (an abnormal heartbeat). It is a bothersome problem, which sometimes causes life-threatening complications. So, your cardiologist suggests cardiac ablation to rectify abnormal heartbeats. It is not the first line of treatment. In most cases, the procedures are suggested by the doctor for people who:

• Fail to get relief from medications prescribed by the doctor for arrhythmia
• Experience serious side effects due to taking medications used to treat abnormal heartbeats
• Suffer from a certain type of arrhythmias like supraventricular tachycardia or Wolff-Parkinson-White syndrome that responds well to ablation.
• Face high risk of complications due to abnormal heartbeats like sudden cardiac arrest

Risks Associated With Cardiac Ablation

The procedure to correct heart problems has several risks associated with it. So, before undergoing the procedure, you need to know that it carried the following complications:

• Bleeding or infection at the site where the doctor inserts a catheter
• Suffer damage to the blood vessels due to scraping by the catheter when it travels to the heart
• Damage to heart valves
• Puncture of heart
• Experience damage to the electrical system of the heart that worsens already existing arrhythmia, leading to the necessity of pacemaker to correct the problem
• Venous thromboembolism (blood clots developing in the legs or lungs)
• Heart attack or stroke
• Veins that carry blood between the lungs and heart narrow, resulting in pulmonary vein stenosis
• Kidney damage due to the dye used in the procedure
• In rare cases, death

So, you need to discuss the risks and benefits associated with the procedure in detail with your cardiologist. Weigh the pros and cons to understand if the procedure is right for you.

Preparing For Cardiac Ablation

Before undergoing the procedure, you need to prepare yourself. The cardiologist will evaluate your condition before the test. So, you have to follow the steps suggested before the procedure:

Undergo Tests

Your cardiologist suggests coming tests before the procedure. It provides information about your heart and overall health. The tests include:

• Blood Tests
• Chest X-ray
• CT (Computerized tomography) scan
• Chest Magnetic Resonance Imaging (MRI)
• Echocardiogram

Food/Drinks

The night before the procedure, you have to stop eating and drinking. It is because food and drinks remaining in your stomach can cause a bad reaction to the anesthesia given during the procedure. Like, you can vomit, which could get inside your lungs.

Medications

You need to inform your doctor about the medicines you take. It is important to get advice from your doctor about the medication you need to take or stop before the procedure. Your doctor can suggest stopping taking the medication used to treat abnormal heart rhythm several days before the procedure.

Special Instruction

Your doctor can suggest special instructions before or after the procedure based on your condition. If you have implanted heart device (for example, implantable cardioverter defibrillator or pacemaker), then you need to take special precautions. Follow the suggestions provided by the doctor.

Cost Of Cardiac Ablation

The cost of the procedure in countries like the USA can range from $16,000 to $ 22,000. But, countries like India offer high-quality medical care in a private hospital at low costs (around INR 97000 to INR 1, 50,000).

Procedure During Cardiac Ablation

In specialty hospitals, you have a special room called the electrophysiology laboratory. The procedure takes place in a special room. You have a team of specialists in the healthcare panel consisting of a cardiologist, a nurse, a technician, and an anesthesia provider. Your healthcare team takes around three to six hours to complete the procedure. Depending on the hospital you choose, the procedure is performed under local or general anesthesia with sedation. You have to stay in the hospital for the procedure.

Before The Procedure

Before the procedure, your doctor inserts an IV (intravenous line) into your forehand or hand. To relax, your doctor provides sedation. Instead of placing you in a sleep-like state, your doctor can provide general anesthesia. The type of anesthesia provided depends on your particular condition. Once the sedative starts taking effect, the doctor numbs the small region near the forearm, neck or groin vein. Through the vein, the specialist inserts a needle and places a sheath (tube) through it. Using the sheath, the doctor threads the catheters and guides them to several places in your heart. Then, a dye is injected into the catheter. It aids in visualizing the blood vessels present in the heart by using x-ray imaging.

The catheters inserted into the sheath have electrode at their tips. It is used by the cardiologist to send electrical impulses to the heart. It can also record the electrical activity of your heart. The process of detecting the abnormal issues causing arrhythmia by using imaging as well as other tests is known as EP (Electrophysiology) study. EP study is opted by the doctor before a cardiac ablation procedure to find the best method to treat arrhythmia.

During The Procedure

After identifying the abnormal tissue in your heart causing arrhythmia, the doctor aims the catheter tips to the exact location of your abnormal heart tissue. Your cardiologist directs energy to the abnormal tissue through the catheter tips to create a scar or destroy it. The procedure aids in blocking the abnormal electrical signals that travel through the heart. So, it prevents abnormal heart rhythm and allows the signals to travel in a correct/normal pathway. The energy used for the procedure can come from the following sources:

• Lasers
• Heat (Radiofrequency)
• Cryoablation (Extreme cold)

A simple procedure can take from three to six hours to complete. But, complicated procedures can take longer. You feel slight discomfort during the procedure, especially when the cardiologist moves the catheter in your heart or while delivering the energy. If you experience issues like shortness of breath or severe pain, then you need to inform your doctor about it.

After Cardiac Ablation Procedure

Immediately after the procedure, you get shifted to the recovery area in the hospital. You need to rest quietly for at least four to six hours, it is to prevent bleeding the catheter site. During your stay in the recovery area, healthcare professionals monitor your heartbeat and blood pressure continuously. It is a monitor to detect any complications of the procedure. You get discharged from the hospital on the same day or next few days based on your condition. In most cases, the doctor makes you stay at the hospital to avoid any complications.

You need to make travel arrangements to reach your home after the procedure. It is not advisable to drive a few days after the procedure. You may feel sore after cardiac ablation. But, it will only last for a few days. You can return to your normal activities a few days after the procedure.

Care At Home After Cardiac Ablation

Once you leave the hospital, you need to follow some steps at home. It is vital for your swift healing and getting back to your normal life.

• You need to follow the instructions provided by the doctor once you get discharged from the hospital. In normal cases, you can return to normal activities seven days after leaving the hospital.
• Avoid driving for a few days (at least twenty-four hours) after you leave the hospital.
• You need to avoid any physical activities for three days after undergoing cardiac ablation. Consult your doctor before you can return to strenuous exercise.
• Refrain from drinking alcohol for twenty-four hours after leaving the hospital.
• You can see a small bruise at the puncture site, which is a normal occurrence. But, if it starts to bleed, then try to stop it by pressing firmly on top of it. Call a doctor or visit the hospital to deal with the problem immediately.
• As your wound heals, it develops into scar tissue. Until the scar tissue forms, you will not have a normal heartbeat. So, you need to wait for several weeks for a normal heartbeat. Until then you can experience the same or worse heart arrhythmia.
• Your doctor prescribes blood thinners for three months after the procedure, which you need to take without fail.
• Some people need to take anti-inflammatory drugs or antacids after the procedure to prevent any complications.

The doctor checks if the procedure corrects your heart rhythm. So, you need to undergo a checkup after a few days or weeks to detect its success. If it is not normal, then the procedure is repeated for it to work.

Recovery Tips After Cardiac Ablation

While you are recovering from the procedure, you need to follow some tips to ensure speedy healing. So, you need to ensure the following:

• Never lift, push or pull any heavy objects. Any object heavier than ten pounds can put a strain on your heart. So, try to refrain from such activities like mowing the lawn for at least a week after the procedure.
• Avoid intense workout routines for three weeks after the procedure. You need to consult your doctor before resuming your exercise routine.
• You need to keep your surgical wounds clean and dry to prevent the risk of infection. At the end of the wound healing stages, it heals. So, until it heals completely take care of the wounds.
• Avoid taking soaking in the bath or using hot water on your wound. Take shower for the first five days after the procedure. Soak the water near your wound by gently patting it to ensure the area is dry.
• Try not to use lotions or creams on the area of the wound.
• If you see signs of infection like swelling, fever, redness or heat at the site, then call your doctor immediately.

Consult Doctor After Cardiac Ablation

After the procedure, you need to monitor the signs appearing on the leg. Some signs indicate a more serious complication that requires immediate medical attention. So, call your doctor immediately when you see the following signs:

• The spot of puncture begins to swell or see fluid drainage from it
• The puncture on your leg becomes numb or tingles
• The area around the puncture site has more bruised appearance
• Your feet turn cold or numb
• Experience shortness of breath
• Feeling lightheaded or dizzy enough to lie down
• Profuse sweating
• Feel sick to your stomach
• You experience irregular or fast heartbeat

You feel discomfort or pain in the chest region that moves to other areas like arm, neck, or jaw

Results Of Cardiac Ablation

The results for cardiac ablation depends on the type of issue and the severity of the condition you suffer. But overall the outlook is good. Your doctor determines the success of the procedure after three months. After the procedure, you need to wait for ninety days to allow healing. The waiting period is also known as the blanking period. If you get the treatment option to manage atrial fibrillation, then 80% of the people can expect positive results. Among them, 70% may not need further medication like antiarrhythmic drugs to stabilize the heart condition.

While 74% of the people undergoing ablation for different supraventricular arrhythmia issues can expect positive results. While the rest of the percentage can experience partial success in the procedure. Only a small percentage of people (9%) face failure. The success rate of the procedure depends on the type of issue you suffer. For frequent issues, you have lower success rates while intermittent problems have high success rates.

Steps To Ensure Long-Term Success Of Cardiac Ablation

Cardiac ablation is successful in most of the cases. But, if you tend to fall into an unhealthy lifestyle after the procedure, you can face the risk of repeat procedures. So, you need to follow the instructions suggested by your cardiologist to the T. Take medications as per the guidelines suggested by your doctor. You must also make some effort to change your lifestyle to improve your heart health as well as your overall health. It will help in preventing or managing conditions (like blood pressure) that can cause or worsen arrhythmias. So, you need to follow the suggestions offered below:

Use Less Salt

Salt is the primary source of sodium. Sodium can increase your blood pressure and enhance the risk of stroke and heart diseases. Therefore, you need to lower your blood pressure levels by consuming less salt. Reduce the amount of salt in your cooking. Also, refrain from eating processed foods that contain high levels of salt.

Increase Your Physical Activity

Your heart muscles can become stronger and healthier when you lead an active life. So, include physical exercises that can burn calories and keep you fit. But, before including any exercises, you need to talk to your doctor about the activities you have in mind. The doctor can offer you guidelines on the limitations you have. Based on the suggestions, include exercises in your routine.

Quit Smoking

You are aware of the fact that using tobacco products increases your risk of lung cancer. But, smoking can also put you at risk of heart problems. Nicotine and other chemical compounds in cigarettes or cigars tighten major arteries. So, it results in irregular heart rhythm. It can make your heart work harder. Smoking can also increase your blood pressure and put you at risk of stroke. So, quit smoking.

Avoid Drinking Alcohol

Using alcohol regularly or in excess can hurt your health, especially if you have undergone cardiac ablation. The alcohol consumption can cause issues to your heart muscles and increase your blood pressure. So, you need to avoid drinking alcohol after the procedure to ensure your heart stays healthy.

Eat Heart-Healthy Foods

A healthy diet including fruits and vegetables can make your heart healthy and slim your waistline. So, if you wish to have a healthy heart, then try to eat whole foods that are good for your health. Include the following heart-healthy foods in your diet:

• Eat nuts as they can help your heart. So, consume a handful of walnuts and almonds for keeping your heart fit.
• Omega-3 fatty acids are good for your heart. Fish like tuna, salmon, trout, herring, and mackerel are good sources of omega-3 fatty acids.
• Berries contain soluble fiber and phytonutrients that are good for your heart. Therefore, try to include blackberries, strawberries, blueberries or raspberries in your yogurt or cereal.
• Certain seeds are also good for your health. For example, chia seeds contain omega-3 fatty acids, protein, and fiber. You can eat as a whole or include your foods as powder. Similarly, flaxseeds contain phytoestrogens, omega-3 fatty acids, and fiber that can boost heart health.

Maintain A Healthy Weight

Excess weight means additional fat deposits in your body. It can cause changes to your heart structure. So, the organ has to work harder to pump blood to all cells in your body. The condition can result in heart problems. So, you need to shed excess pounds accumulated in your body. You can use an effective weight loss program along with workout routines to achieve a healthy weight. If no methods work, then opt for bariatric surgery to reach your weight loss goal.

Manage Strong Emotions

Experiencing strong emotions like anger, emotional stress, etc. can affect your heart. People who have heart disease become more vulnerable to the problem. So, after undergoing cardiac ablation, you need to keep your emotions under control. Depression, worry, anxiety, anger can cause severe irregular heart rhythms. So, you need to take to your cardiologist or primary care physicians about the emotions. They can suggest consulting a psychiatrist who can help you deal with self-esteem issues. You need to undergo some therapies to protect your psychological state and prevent heart problems in the future.

Conclusion

If you have heart problems like arrhythmia, a problem causing issues with the rhythm or rate of your heartbeat, then you need to undergo cardiac ablation. The procedure is the least invasive one to improve the condition. You need to follow the instruction suggested by the doctor after the procedure to ensure the best results. So, you need to make an appointment for the follow-ups, take medications as per schedule, and include safe levels of physical activity. With proper care, you can get back to your normal routine without any delay.