Having cardiac ablation

An ablation procedure is a treatment for a heart condition called atrial fibrillation. This is an irregular heart rhythm, which starts in the upper chambers (atria) of the heart.

We can do an ablation procedure to treat areas of the heart involved in heart rhythm problems. If you have atrial fibrillation, we will target the atria with ablation treatment.

Preparing for the procedure

This section gives you practical guidance on how to prepare for your ablation procedure.

Eating and drinking

On the day of your procedure, you must:

• not have anything to eat from midnight onwards
• only have sips of water until 6am

At your pre-assessment appointment, we tell you the exact time that you need to stop eating (fast) before your procedure. For more details, please read our information about having an anaesthetic (a medicine to make you sleep during the procedure).

Your admission pack includes the date, time and place that you need to come into hospital.

Your medicines

We give you personalised advice about which medicines to take or stop taking at your pre-assessment appointment. 

If you take a medicine called warfarin, we may ask you to have blood tests every week. You need to do this in the 4 weeks leading up to your procedure. The tests measure how long it takes your blood to clot (this is called your international normalised ratio or INR).

We will explain in advance if your risk of having a stroke is higher than usual. You may have started taking medicines called anticoagulants that help to prevent blood clots. It is important to follow your health professional's advice about which medicines you need to take.

Getting ready on the day of the procedure

Here is some guidance to help you get ready on the day of your procedure:

We make small cuts in the groin during the procedure and can talk to you about this at your pre-assessment appointment. If you do not manage to shave your groin area, there is no need to worry. We can do this after you have the anaesthetic for your procedure.

Travel arrangements

You need to arrange for someone to collect you from the hospital and accompany you home after the procedure. If you need patient transport, please contact us. 

Please be aware that not everyone is eligible for patient transport. We can only offer free transport if you:

• have a medical need or condition that prevents you from using public transport
• cannot travel to and from the hospital in any other way

When you contact us, we check whether you qualify to use our patient transport service.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have an ablation procedure to treat atrial fibrillation, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

You can read more about our consent process.

During the procedure

You usually have an ablation procedure for atrial fibrillation under general anaesthetic. This means that a specialist anaesthetic doctor called an anaesthetist gives you medicine through a small tube in a vein of your arm. The medicine makes you sleep and stops you feeling any pain during the procedure.

When you are asleep, we do an ultrasound test called a transoesophageal echocardiogram. This a test to:

• make sure that you do not have a blood clot in the heart
• check how your heart is working

We pass a thin device called an ultrasound probe from your mouth into your food pipe (oesophagus). If we see a blood clot within the heart, we will stop the procedure and not continue with the ablation. 

Before arranging another ablation procedure, we will review or change your anticoagulant (blood-thinning) medicines to dissolve the blood clot.

Please tell the pre-assessment nurse and doctor before the procedure if you:

• have any problems with swallowing
• previously had surgery on your throat or food pipe

This might affect whether we can use an ultrasound probe.

After the ultrasound test, we make small cuts at the top of your right leg in the groin area. We then put thin, flexible electrode catheters through these cuts into the femoral vein (a large blood vessel in your thigh). From there, we pass the catheters up to the heart on the inside of your body.

We target the specific area of the heart that is causing your irregular heart rhythm with:

• heat energy (radiofrequency ablation)
• very cold temperatures (cryoablation)
• electrical impulses (pulsed field ablation)

How the procedure feels

You are likely to have an ablation procedure for atrial fibrillation under general anaesthetic. This means that you are asleep during the procedure and should not feel any pain.

After the procedure, you might feel a small amount of discomfort in your groin where we made the cuts. You might also have some chest pain, which will get better. This should be easily managed with pain medicines that you can buy from a pharmacy or shop.