Electrophysiological Studies and Ablation

What is ablation ?

Ablation is a procedure to alter the electrical activation within the heart, undertaken to reduce the symptoms associated with heart rhythm disturbances.

What happens during an electrophysiological study?

The procedure can be done either under local anaesthetic with sedation, or under general anaesthetic, and this will be discussed with you. Small thin tubes called sheaths are inserted into the vein at the top of the leg, these allow the ablation catheters to enter the vein and be guided up to the heart using the x-ray machine.

The small wires (catheters) are positioned within the heart and allow the hearts electrical activation patterns to be recorded.

The heart is then stimulated and the electrical activation patterns are tested using a computer.

The operator will often to try to start your heart rhythm disturbance so that it can be traced and the target for any treatment identified. This is done in a controlled way, where the heart rhythm can be started and stopped by the computer.

If ablation is recommended, this is also delivered through a catheter. The catheter is placed in position and the tip of the catheter is heated to ablate the heart tissues, and prevent conduction through that spot. Some rhythms require multiple ablation lesions, others just need one.

Testing is done again after the ablation to check success, and is often undertaken for 20 mins to ensure a long lasting lesion is created.

After the procedure you need to lie flat for a period of time to ensure that the small hole in the vein at the top of the leg seals, you will often be allowed home the same day.

Who should have an ablation ?

Ablation is offered as a treatment option for patients with symptoms due to heart rhythm disturbances. There are many different rhythms and your doctor will advise if ablation is a treatment option for you.

What is the success rate of the procedure?

Success rates vary depending on the rhythm and your individual circumstances. For some rhythms the success rate can be as high as 95%, whilst for others it can be lower than 70%. Your doctor will discuss this with you directly.

What are the risks ?

Ablation, like other medical procedures, carries with it significant risks, thankfully these are uncommon.

The risks for any individual person depend on many factors and will be discussed in detail. The main risks include: Failure to control symptoms, bleeding, damage to the hearts own electrical systems needing a pacemaker to be implanted, perforation of the heart, the need for emergency cardiac surgery, stroke, damage to the nerve that control the diaphragm (the main muscle that controls breathing), damage to the vein or artery at the top of the leg, damage to your heart valve, heart attack and very rarely death.

It is very important that you understand all the risks and the benefits of having the procedure, and this will be discussed with you in detail at your appointment.

Where are the procedures done ?

The electrophysiological studies and / or ablation procedures are offered in Spire Shaw Fair Park hospital in Edinburgh, and BMI Ross Hall Hospital in Glasgow. The consultations to discuss management and outpatient care before and after the procedure can be offered in any of the clinics in Dundee, Edinburgh or Glasgow.