What is involved in a radiofrequency ablation procedure?
You will be transferred to the Electrophysiology Laboratory (EP lab) from your ward. Usually before leaving your ward you will be given a light sedative and your groin will be shaved.
The EP lab has a patient table, X-Ray tube, ECG monitors and various equipment. The staff in the lab will all be dressed in hospital theatre clothes and during the procedure will be wearing hats and masks.
Many ECG monitoring electrodes will be attached to your chest area and patches to your chest and back. These patches may momentarily feel cool on your skin.
A nurse or doctor will insert an intravenous line usually into the back of your hand. This is needed as a reliable way to give you medications during the study without further injections. You will also be given further sedation if and as required. You will also have a blood-pressure cuff attached to your arm that will automatically inflate at various times throughout the procedure.
The procedure may be performed either under local anesthetic with sedative medication to make you feel relaxed and comfortable or under general anesthetic with you completely asleep. You will be able to discuss the approach with your doctor and the anesthetist.
The oxygen level of your blood will also be measured during the procedure and a small plastic device will be fitted on your finger for this purpose. Your groin area and possibly your neck or arm will be washed with an antiseptic cleansing liquid and you will be covered with sterile sheets leaving these areas exposed.
The doctor will inject local anaesthetic to the area where the catheters are to be placed. After that, you may feel pressure as the doctor inserts the catheters but let the staff know if there is any discomfort so some more local anesthetic can be given. Once the catheters are in place you may feel your heart speeding up. This is due to the electrical stimulation of the heart by the catheters. If your heart is in a normal rhythm at the time of the procedure, your doctor may possibly want to induce atrial flutter. This allows the doctor to determine the exact location of the flutter in order to allow its cure.
What is radiofrequency ablation (RFA)?
Radiofrequency is a low power, high frequency energy that causes a tiny region of the heart near the tip of the catheter to increase in temperature, thus ablating a small area of tissue.
Radiofrequency energy has been used for decades by surgeons to cut tissue or to stop bleeding. For the treatment of palpitations, a much lower power of radio-frequency is used.
The electrical catheters are usually inserted into the heart via a vein in the groin area. Occasionally a vein in the side of the neck is also used.
The electrical catheters are positioned using X-Rays to guide the placement and also by using electrical recordings from inside the heart.
The short-circuit is then localised electrically and a small burn created at the weak-link in the short circuit.
The atrial flutter ablation procedure may take approximately 2-3 hours on average.