Radio Frequency Ablation (RFA)
RFA is an invasive cardiology interventional procedure that destroys the abnormal electrical cells that are causing an abnormal heart rhythm. It utilizes the techniques of cardiac catherization described above to deliver specially made electrode catheters into your heart. The procedure is similar to an electrophysiology study and takes approximately three to eight hours to complete.
Preparing for the Hospital
The following general guidelines for RFA do not replace the specific instructions given by your cardiologist. There may be certain circumstances unique to each patient where different instructions are necessary. Always follow your physician's instructions and contact your physician if you have any questions.
- Do not eat or drink anything six to eight hours before the procedure. Small sips of water are allowed to take medications.
- Do not drive to and from the hospital. Someone else should give you a ride.
- Your physician may decide to keep you overnight so you should pack a small bag with a robe, pajamas, slippers and toiletries.
- Make a list of all your medications including the exact name of the medication, the dosage and how often you take them.
- Inform the nurse or physician if you have any allergies to medications or have had allergic reactions to X-ray dye (contrast), iodine or have a history of bleeding problems.
- Before the procedure, stop at the restroom and empty your bladder.
The Procedure
The RFA procedure is performed in an electrophysiology laboratory (EP Lab). Once inside, you will be shaved and draped with sterile cloths as necessary. EKG and blood pressure monitors will be attached, and a local anesthetic is used at the catheter insertion site. During the procedure you will be sedated and may sleep intermittently. General anesthesia is not used.
To measure the exact electrical impulses in your heart, your cardiologist will insert three to six catheters into your heart. Your cardiologist uses these catheters to perform three duties. First, these wires are connected to a computer and electrical filter system that records all the information, thus allowing for evaluation of the electrical impulses recorded. Second, the wires can deliver tiny electrical impulses to pace or control the heart rate. Third, certain catheters are used to send radiofrequency energy to cauterize (or block with scar tissue) the abnormal electrical tissue. You will not feel any discomfort during the cauterization.
During the procedure, your cardiologist will send a variety of electrical impulses to your heart. You will not feel these impulses, but you may sense a change in heart rate. Your cardiologist may send early beats to check the electrical stability of your heart and is likely to trigger the same fast heartbeat that is causing your problems. This helps your cardiologist determine the type of fast heartbeat that is occurring.
Once your cardiologist has identified the type of heartbeat you have, a catheter is used to map the electrical circuit. Your cardiologist then determines which area of that electrical circuit to eliminate.
Radiofrequency energy is delivered through a catheter to the identified site, eliminating that tissue. Only a very small amount of heart tissue is involved. After the ablation, you are monitored for 30 to 60 minutes to ensure the ablation was successful. The catheters are then removed and pressure applied to the catheter entry site to stop any minor bleeding.
After the Procedure
You will be brought to your room where nurses monitor your blood pressure, heart rate and catheter insertion sites. It is important that you lie still to allow the insertion sites to heal. Two to six hours of bed rest in the hospital follow. You can expect to stay in the hospital for one to two days after the procedure.
Going Home
You should limit activity for the first 24 hours and allow the insertion site to heal. Avoid heavy lifting, swimming or physical activity. You may take showers. A nonprescription pain reliever may relieve any discomfort. Call your physician if the insertion site looks infected.
Physical activity should be limited for the first week, which means no physical exertion beyond lifting 10 pounds or a gentle, leisurely walk. Your cardiologist will review with you when you can return to a regular activity level.
Medications should be taken as directed.
If your symptoms recur, such as rapid heartbeat, call your physician right away.
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