What Is the Ablation Procedure?

An ablation is a minimally invasive procedure that is used to treat uterine, cardiac and other types of conditions.

An ablation procedure is a minimally invasive procedure. It is used to destroy layers of abnormal tissues in various parts of the body using lasers or cold. Ablation can be done for cosmetic reasons (on the skin for brightening, wart removal and tattoo removal) or treating serious disorders (heart ablation to treat abnormal rhythm or uterine ablation for fibroids).

Cardiac catheter ablation is a procedure that destroys a small area of the heart tissue that is causing rapid and irregular heartbeats.

• The doctor may give local or general anesthesia to the patient to numb the pain.
• The doctor inserts thin, flexible wires called catheters into the patient’s vein through a small incision, typically in the groin or neck, and threads them up into their heart.
• There is an electrode at the tip of the wires. The electrode sends out radio waves that create heat. This heat destroys the heart tissue that causes abnormal heart rhythms. Electrodes on the end of the catheter create tiny scars on the wall of the heart.
• In some instances, the doctor may use freezing cold to destroy the heart tissue.
• Sometimes, abnormal impulses come from inside a pulmonary vein and cause abnormal heart rhythms. (The pulmonary veins bring the blood back from the lungs to the heart.) Catheter ablation in a pulmonary vein can block these impulses and keep abnormal heart rhymes from occurring.
• Catheter ablations typically take three to six hours. After ablation, the patient will wait several hours in the recovery area.
• Most patients who have ablation procedures go home the same day, whereas some patients need to stay overnight in the hospital.
• For two to three days after the procedure, the patient may have these symptoms
  • Tiredness or weakness
  • Achy feeling in the chest
  • Skipped heartbeats or times when the heartbeat is very fast or irregular

Depending on the results of the ablation procedure, the patient may still need to take medication to help control arrhythmias. Some patients may require repeat cardiac ablation treatment at some point.

Common conditions or the types of abnormal heart rhythms that are treated by cardiac ablation procedure include

• Atrial fibrillation (AF): This is the most common type of cardiac arrhythmia (irregular heart rate or rhythm). It occurs when electrical signals from the heart’s two upper chambers “fibrillate” or quiver.
• Atrial flutter (AFL): This is a condition related to AF. AFL occurs when the atria (upper chambers) of the heart flutter at a regular and rapid rate, usually around 250 to 300 beats per minute (bpm).
• Ventricular tachycardia (VT): This is a rapid type of heartbeat that starts in the ventricles (lower part of the heart).

There are other types of cardiac ablations

Apart from catheter ablation, other types of ablations include

• Hybrid surgical-catheter ablation: This ablation procedure combines catheterization with thoracoscopic surgery, a minimally invasive surgery involving a few small incisions in the abdomen. Surgeons begin the hybrid procedure using a thoracoscope (a thin, lighted tube with a tiny camera at the end) and long, thin instruments. They access the area outside of the heart to perform the ablation. Electrophysiologists then perform catheter ablation through it.
• Surgical ablation: This procedure uses minimally invasive laparoscopy and open-heart surgical procedures. Surgeons use either energy (hot or cold) or make cuts to create scar tissue on the heart. The scar tissue disrupts arrhythmias and creates new electrical pathways to restore a normal heartbeat pattern. Because surgical ablation is more invasive, patients usually have it only if they are already undergoing surgery for another heart condition.
• Uterine ablation: This procedure is used to destroy the non-cancerous growths in the uterus called fibroids.

Percutaneous tumor ablation: This refers to a range of techniques that destroy the tumor tissue through needles placed through the skin. The goal of tumor ablation is to destroy the tumor without performing surgery. Whether the patient is suitable for this procedure depends on the size and location of the tumor and the patient’s clinical situation.

• Some techniques use chemical agents such as absolute ethanol.
• Others use physical agents that may be thermal (using heat) or non-thermal.
• Thermal ablation techniques destroy tumors by using different types of applicators to freeze the tumor (called cryoablation) or to heat the tumor such as radiofrequency ablation, laser ablation, microwave ablation and high-intensity focused ultrasound (HIFU).
• Non-thermal ablation techniques use other sources of energy to achieve tumor destruction.
• The procedure will be performed using image guidance such as an ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) to control the insertion of the devices and energy deposition.
• The radiologist will anesthetize the patient for the procedure. For most ablation procedures, the interventional radiologist will insert one or more needles or applicators into the tumor to deliver the chemical agent or physical energy.
• The risk may involve bleeding or puncture of the surrounding organs. Another risk is the accidental leakage of the chemical agent or uncontrolled depositing of radiation energy, which may cause serious damage to the surrounding tissues.