FREQUENTLY ASKED QUESTONS

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Ablation

What is ablation?
Ablation destroys (ablates) targeted portions of the heart muscle. Your doctor carefully chooses portions of the heart muscle to treat. Then your doctor delivers small amounts of energy to these selected areas. This creates lesions (helpful scars) on the heart muscle.

Ablation can be done as a type of surgery or as a procedure using a catheter. A catheter is a flexible tube that is inserted into a blood vessel.

Your doctor will decide whether a catheter ablation or a surgical ablation is right for you. This section describes both catheter and surgical ablation.

Other names for ablation: cardiac ablation, catheter ablation, cryoablation, microwave ablation, radiofrequency ablation, surgical ablation.

How is it done?

Catheter ablation
Catheter ablation does not require incisions in the hest. This type of ablation begins with a catheterization. During a catheterization, a small flexible tube called a catheter is inserted through a blood vessel in your groin (or sometimes in your neck). Your doctor gently “steers” the catheter into your heart. Your doctor can see where the catheters are going by watching a video screen with real-time images, or moving x-rays, called fluoroscopy.

The electrode at the tip of the catheter senses your heart’s electrical signals and takes electrical measurements. Your doctor tests your heart and then “ablates” sections of the muscle tissue using the catheter. Catheter ablation can be done using:

• Intense cold, called cryoablation
• High-frequency energy, called radiofrequency ablation

In some cases, when ablation is done in certain parts of the heart, you may need a pacemaker afterwards.

Surgical ablation
Minimally invasive surgical ablation requires six small incisions in the sides of your chest. These incisions (1/2 to 3/4 inches in size) are much smaller than the incisions needed for traditional open-heart surgery. Through these incisions, your doctor inserts a tiny camera to view the heart. Your doctor then inserts small instruments to test your heart and ablate the tissue as needed.

Open-heart surgical ablation requires a longer incision down the middle of the chest, through the breastbone (sternum). This type of ablation is usually done if you also need to have another type of treatment, such as a valve replacement or bypass surgery.

With either type of surgical ablation, your doctor ablates sections of the heart muscle tissue by delivering energy to the heart and creating lesions (scars). Surgical ablation can be done using:

• Intense cold, called cryoablation
• Microwave energy, called microwave ablation
• High-frequency energy, called radiofrequency ablation
• Ultrasound energy

What can I expect?
Usually you are told not to eat or drink anything for a number of hours beforehand. Catheter ablation is performed in a “cath lab.” And surgical ablation is performed in an operating room. You lie on an exam table and an intravenous (IV) line is put into your arm. The IV delivers fluids and medications.

A few details about each type of procedure or surgery is explained as follows.

Catheter ablation
The medications in the IV make you groggy, but not unconscious. To insert the catheter, the doctor makes a small incision in the groin (or the neck), but not in the chest. The area will be numbed so you shouldn't feel pain, but you may feel some pressure as the catheter is inserted. During ablation your doctor or nurse might ask you questions. Afterwards you may be in the hospital overnight.

Minimally invasive surgical ablation
During a surgical ablation, you will receive medication that makes you unconscious. You will not be aware of the incisions made in the side of your chest, or of the ablation itself. After surgery you will probably be in the hospital for one to two days.

Open-heart surgical ablation
During a surgical ablation, you will receive medication that makes you unconscious. You will not be aware of the incision in your chest, or of the ablation itself. After surgery you may spend several days in the hospital. You may have pain at the incision site for several weeks. Your recovery will depend in part on the other heart surgery you likely had done at the same time as the ablation.

Important Safety Information
Medications, procedures and tests can have some risks and possible side effects. Results may vary
from patient to patient. This information is not meant to replace advice from your doctor. Be sure to talk
to your doctor about these risks and possible side effects.

GUIDANT is a trademark and HEARTISTRY is a service mark of Guidant Corporation.

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