Performing an ablation

During this intervention:

– It is necessary to be fasting, lying on an X-ray table located in a specially equipped room.

– The catheters are introduced under local anesthesia by puncture of a vein or an artery at the level of the groin crease or neck or chest. They are placed inside the heart chambers under radiological control.

– Local anesthesia, sometimes combined with sedative treatment, may be sufficient, but for greater comfort, general anesthesia is frequently performed.

– The duration of the procedure depends on the difficulty of locating the areas requiring ablation. It can last from one to several hours.

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Cardiac pacing tests (voluntary acceleration of the rhythm by the catheters in place) are often performed to specify the arrhythmia and guide treatment. An external electric shock performed during a brief general anesthesia may be necessary during the operation. In some cases, other materials may be used.

– In order to avoid local bleeding after the procedure, compression is performed at the puncture points. If it is an artery, a strong, sometimes painful compression is necessary and a compression bandage is left in place: you must lie down, avoiding bending the leg for several hours after the operation.

 

​Are there any risks associated with ablation?

Among the complications identified by surveys carried out in many French, European and North American centers, most are benign:

– hematoma, transient discomfort at the puncture site;

– transient chest pain.

But some are more severe and rare (1.5% in the French experience):

– pericardial effusions (bleeding in the envelope surrounding the heart) or in the chest that sometimes need to be evacuated urgently, by a needle inserted through the skin or surgically;

– conduction disorders requiring the placement of a permanent pacemaker, when the operation is performed in a region close to the pathways that normally conduct electrical impulses from the atria to the ventricles;

– heart rhythm disorders that may require an electric shock;

– thromboembolic events due to the formation of blood clots that can migrate into the circulation. In an attempt to prevent these accidents, anticoagulant treatment may be instituted during the operative period;

– vascular lesions of the vessels through which the probes are introduced that may require surgical treatment;

– damage to a coronary artery, aorta or heart valve.

 

The risk of a serious course leading to death is rare (4/10,000 in the French register). All precautions are taken before, during and after the operation to limit these risks as much as possible.

 

What benefits can be expected from ablation?

The elimination of the areas that are the cause of arrhythmias makes it possible to prevent their recurrence and their consequences, including serious ones.

In the usual indications and depending on the type of tachycardia or electrical abnormality, ablation is effective in the majority of cases. The risk of recurrence is generally in the order of 5 to 10%. Ablation results in the complete disappearance or significant reduction of symptoms and complications related to the arrhythmias being treated. It makes it possible to reduce or even eliminate drug treatments that may have been poorly tolerated or insufficiently effective.

 

The resumption of professional activity or daily life will be explained to you in a way adapted to your personal situation by the doctor and his team. There are patient associations that can also listen to you.