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catheter ablation (including radiofrequency and cryoablation)

cardioversioncatheter ablation (including radiofrequency and cryoablation)
implantable cardioverter defibrillator (icd)Cardiac Resynchronization Therapypermanent pacemaker
Stereotaxis3-D Electrophysiologic Mapping

1. Why did my doctor order a catheter ablation?
Your heart has an electrical system that helps it beat at a regular speed or pace. If your heart beats too fast, your physician may order a catheter ablation to destroy the cells that are causing your heart rhythm problem.

2. What is a catheter ablation?
A catheter ablation is a minimally invasive procedure that is used to treat heart arrhythmias by destroying the heart tissue causing the problem.

3. What preparations will I need to make?
You will be admitted to the hospital on the day of the procedure. Your doctor will tell you not to take your medications that day. Prior to that day, your doctor may send you for a blood test, electrocardiogram (EKG) or other routine test. You will also be asked to fast from midnight on prior to the procedure. Before you are taken to the electrophysiology lab, the skin on your groin, neck, shoulder or arm will be washed and may be shaved. You may also be given a mild sedative to help you relax through an intravenous (IV) line or in pill form.

4. How is the catheter ablation performed?
After local anesthetic is applied, a thin, soft-coated wire or catheter is inserted into a vein or artery in the groin, neck, shoulder or arm. The catheter is then moved toward the heart, manually or using remote magnetic navigation [link to Stereotaxis page].

An electrophysiology study (EPS) or 3D intracardiac ultrasound [link to 3D Intracardiac Ultrasound page] may also be used to help pinpoint where the ablation should be done.

When the exact location is found, an energy source, such as radiofrequency waves (radiofrequency ablation) or extreme cold (cryoablation), is sent through the catheter to destroy the problem cells, while the rest of the heart muscle is unharmed.

5. How long will the procedure last?
The procedure will last two to six hours.

6. What will the recovery be like?
After the procedure, you'll need to lie down for four to six hours to allow the insertion site to heal. A nurse will continually check your blood pressure and incision. Before you return home, you may have a chest x-ray and other tests. Your hospital stay may be a day or two.

7. What happens after the ablation?
You will probably be allowed to return to your normal activities within a day or two. It is common to find a small bruise or lump under your skin where the catheter was inserted. It should go away within a few days. You should contact your doctor if you run a fever, feel increased pain or numbness at the insertion site, feel chest pains or shortness of breath, feel heart rhythm problems return, or notice that the bruise or lump at the insertion site grows larger instead of reducing.

8. What health risks are involved?
The benefits of a catheter ablation far outweigh the risks of the procedure. However, there are a few risks you should be aware of before you sign the consent form. These risks include: bleeding; blood clots; perforation of the heart muscle, blood vessel or lung; heart block (requiring a permanent pacemaker); damage to a heart valve; stroke or heart attack (rare); death (extremely rare).

9. Will my insurance cover this?
Depending on the type of coverage, most commercial insurance carriers will pay the major share of the cost. You should always consult your insurance company to determine proper coverage.

10. Who should I contact with questions about this test?
Feel free to consult your doctor.

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