Treatment: Ablation for heart rhythm disorders other than atrial fibrillation

The most common type is atrial fibrillation, but several others can also be treated with ablation. These include atrial flutter, AVNRT, WPW syndrome, ventricular tachycardia, focal atrial tachycardia, and atrial and ventricular extrasystoles.

Ablation is an effective treatment for various heart rhythm disorders. During the procedure, a catheter is guided through the blood vessels to the heart. The cardiologist can then use heat, cold or a high-voltage current to destroy small areas of heart tissue causing arrhythmias.

The different types of ablations are known as:

• Radiofrequency ablation / RFA (heat)
• Cryoablation (cold)
• Pulsed Field Ablation / PFA (electric pulses)

If you suffer from a heart rhythm disorder, ablation may be a good option for you.Aablation for atrial flutter is effective in approximately 90% of cases. For most types of heart rhythm disorders other than atrial fibrillation or atrial flutter, ablation is effective in more than 95% of cases.

Before your treatment, you will receive a letter informing you about fasting, medication, shaving and what to bring with you in connection with your treatment.

If you have an ablation, you are welcome to bring a companion, but this is not necessary as you will be able to drive and use public transport (including flights) the day after the procedure. You are also welcome to bring a weekend bag or carry-on suitcase containing some spare clothes and toiletries.

It is not necessary to take blood-thinning medication before your ablation. However, if you are used to taking blood-thinning medication, you must continue to take it before, during, and after the ablation. Should there be any changes, you will be informed.

An ablation procedure for heart rhythm disorders lasts approximately two hours and is performed under local anaesthetic often in combination with general sedation. The procedure rarely causes pain.

A plastic cannula will be inserted into a vein in your arm. Your blood pressure and pulse will be monitored, and blood samples will be taken, as well as an ECG being performed.

Thin catheters are inserted into the heart via blood vessels in the groin. These catheters enable electrical currents in the heart to be measured. It is often possible to trigger the arrhythmia you are experiencing using weak electrical pacing pulses. Measurements are taken at various points in the heart and, once the cause has been identified, the tip of the catheter is placed against the inside of the heart wall. The cause of the arrhythmia is then eliminated by gently heating the tip of the catheter to around 65 degrees or delivering high-voltage electrical current, a process that takes a few minutes. You will not be able to feel the catheters in your heart.

You will be monitored by a nurse for two hours following an ablation. You will need to lie flat in bed to minimize the risk of bleeding from the puncture sites in your groin.

You must inform the nurse if you experience any discomfort, pain, a sensation of heat or swelling in your groin.

Your appointment letter will state when you are expected to be discharged.

You can drive or use public transport (including flying) the day after the procedure.

You can expect a small bruise in your groin at the injection site. Some patients may experience a slightly larger accumulation of blood, which may cause discomfort for the first few weeks following treatment.

For the first week, you should protect your groin by avoiding heavy lifting and long walks, for example. We recommend waiting two weeks before taking part in sports.

You can return to your normal work approximately one week after discharge. However, if your work involves particularly heavy physical labor, you should wait two weeks before resuming it.

Many patients experience headaches and pain, tightness or a dull ache in their chest during the first few days following treatment. If this is the case, Paracetamol may help relieve the discomfort.

In rare cases (less than 1% overall risk), the following complications may occur:

• Larger blood accumulation at the puncture site in the groin
• Accumulation of blood in the pericardial sac
• Air in the pleural cavity
• Formation of small blood clots in the blood vessels, heart or other organs (e.g. brain, kidneys, lungs).

These complications may require observation or special treatment, which can be carried out on site. You will be informed of your risk during your consultation with the specialist prior to treatment.

With certain types of arrhythmias, there is a small risk (less than 1%) that the treatment may inadvertently damage the heart’s normal conduction system. If this occurs, it may be necessary to implant a pacemaker after a period of observation. This procedure can also be performed at our clinic.