What is an ablation?
An ablation is a minimally invasive procedure which involves inserting a catheter through a needle in the groin. Using heat or cold, a scar is then created in the electrical network that causes the rhythm problem. A heart rate that is too fast, like atrial fibrillation or life-threatening ventricular tachycardia (VT) and ventricular fibrillation (VF) can be treated with ablation.
One specific feature at UZ Brussel is that cold is used instead of heat for the ablation process. The UZ Brussel network is the only place in Belgium that carries out cold or cryo-ablation. The advantage of using cold is that your rhythm problem can be treated very efficiently and in a very short procedure.
Not all rhythm problems can be treated with ablation; some patients will need medication or a pacemaker. About 4% of patients who have an ablation will need a pacemaker afterwards.
About 10% of patients will have heart rhythm problems again later on. A second and in some cases a third ablation may be necessary to deal with the rhythm problem permanently. If the rhythm problem persists, a hybrid ablation can be considered.
After discussion with your doctor, preparatory tests such as blood tests, an electrocardiogram or echocardiogram are arranged.
During the procedure
Just before the test a drip will be placed in your arm so that you can be given medications during the test if needed. The ablation itself is done under a general anaesthetic in the catheter laboratory or cath lab. The cath lab is similar to an operating theatre. During the test you will be lying on a special table surrounded by a huge array of specialist equipment. The various machines you can see will show images of your heart and influence and monitor your heart rhythm.
After the procedure the catheters will be removed and you will need to stay in bed for at least four hours to minimise the risk of bruising from the place where the catheters were inserted. If the needle has been inserted in an artery rather than a vein, you will need to remain lying down for longer.
Meanwhile the nurse will monitor your heart rhythm and blood pressure and the place where the needle was inserted in the groin (or neck) will be checked regularly.
When the nurse gives you permission to get up and after the doctor providing your treatment has discussed the results with you, you can go home. Meanwhile, if you have any questions or need information about practical formalities, you can talk to the lead nurse about this.
Back to work
You can usually resume your normal activities 24 hours after the test or treatment. If you were unfit for work before the test or treatment, you must discuss with the doctor when you can go back to work. For some patients the doctor can decide that going back to work is permanently impossible due to the nature of the problem.