Your electrophysiologist and other healthcare specialists in the lab will use a variety of imaging and advanced monitoring systems to help them navigate the catheters to your heart, locate the precise location for the ablation, and evaluate their progress. Also, depending on your anatomy, some ablation specialists will take extra steps to avoid damaging tissue near your esophagus. They may ask you to drink a creamy substance to help the esophagus show up better on the x-ray.
Catheter ablation uses a series of thin, flexible wires (catheters) that are inserted through an artery or a vein (usually in the groin or neck) and guided to the heart. The position of the catheters can be seen using fluoroscopy, a special monitoring technique that uses x-rays. Once in the heart, one or more of the catheters are used to pinpoint the source of the abnormal electrical signals.
Medications will be given to increase your heart rate. You may also be given a drug or electrical stimulation to bring on the abnormal rhythm. This will help the doctor identify the areas of the heart producing the arrhythmia. Some people may feel some temporary chest discomfort during the procedure. If that happens to you, be sure to tell your doctor, who can give you medication to relieve it.
When your electrophysiologist has located the source of your arrhythmia, he will move another catheter to the site. That catheter delivers bursts of high-energy waves that ablate, or destroy, the abnormal areas. This creates a small scar (called a “lesion”) that electrical signals cannot pass through. After ablating the problem areas, your electrophysiologist will try to re-start your arrhythmia. If the abnormal rhythm cannot be induced in this way, then the procedure is a success. If a fast rhythm does return, further ablation may be needed. The whole procedure (including the EP study and mapping) may take several hours.