Heart ablation treats irregular heart rhythms. Yet, sometimes, arrhythmias may return after treatment. You can repeat the procedure, but studies show it works less well after several tries. Research is looking into how often ablation can be helpful. It may work well at first, but there seems to be a limit on its long-term success.
How many heart ablations? The magic number
There’s no strict limit on heart ablations, but experts say the benefits drop after two or three. The patient often makes a choice. Yet, studies and doctors caution that more ablations likely won’t provide lasting relief.
A 2016 study in the Journal of Atrial Fibrillation shared key findings. The researchers observed important aspects of treating atrial fibrillation and its outcomes.
- A heart ablation can end atrial fibrillation in 60 to 80 percent of patients. This shows great results for many people after one procedure.
- Patients with atrial fibrillation may enjoy a second heart ablation three months later. This procedure focuses on pulmonary vein isolation and non-PV triggers. It resolves the issue in around 75% of cases.
- Patients who didn’t get lasting results from the second ablation took antiarrhythmic drugs. They used these drugs to manage their atrial fibrillation.
What is a heart ablation meant to achieve?
Heart ablation, also called cardiac ablation, aims at small heart tissue areas. These spots mess with normal electrical signals, causing irregular heartbeats. It is most often used to treat specific types of arrhythmias.
- Atrial fibrillation (a-fib).When the heart’s upper chambers, called atria, shake instead of pumping properly, blood flow to the body decreases. This condition is different from ventricular fibrillation. Ventricular fibrillation is a dangerous arrhythmia in the heart’s lower chambers. It can lead to sudden cardiac arrest. V-fib is a medical emergency. It needs immediate CPR and defibrillation. Use a device like the LIFEPAK CR2 or Philips HeartStart FRx.
- Atrial flutter. When the heart’s upper chambers beat too quickly, they can’t empty or refill properly. This makes it hard for the heart to pump blood well.
- Ventricular tachycardia (v-tach). This dangerous rhythm happens when the heart’s lower chambers beat too fast. They can’t pump blood well. It can occur with or without a pulse. If there’s no pulse, it can quickly lead to cardiac arrest. This requires urgent CPR and defibrillation.
- Supraventricular tachycardia. This arrhythmia makes the heart beat faster in the upper chambers. It can reach 150 to 220 beats per minute. Mild episodes often go away on their own in minutes or days. Yet, serious cases can be life-threatening and may cause cardiac arrest.
Arrhythmias aren’t always deadly, but they can increase the risk of serious issues. These include stroke, heart attack, and sudden cardiac arrest. They can cause discomfort. This may lead to symptoms like palpitations, dizziness, fatigue, or shortness of breath. Often, this happens due to poor circulation of oxygen-rich blood.
After diagnosing an arrhythmia, doctors usually start with antiarrhythmic medications. These meds are less invasive. If the condition doesn’t improve, cardiac ablation may be suggested as an alternative. Some patients choose to skip medication. They do this because of side effects, such as nausea, dizziness, or headaches. One or two ablation procedures can often fix a normal heart rhythm. This is especially true for persistent atrial fibrillation.
How the cardiac ablation procedure works
There are three kinds of cardiac ablation:
- Catheter ablation
- Surgical ablation
- Hybrid surgical/catheter ablation
Catheter Ablation
During a catheter ablation, doctors insert small tubes into veins in the groin. This is done with local or general anesthesia. Electrode catheters are guided to the heart through these tubes. X-ray imaging helps with this process.
The electrode catheters go to the heart and use advanced technology. They identify the faulty electrical signals that cause the arrhythmia. These areas are treated with either heat from radiofrequency or cold from cryoablation. This stops the irregular rhythm.
Following the procedure, patients typically remain in the hospital overnight for monitoring. A short period of rest, usually about a week, is recommended afterward. You might get blood thinners or antiarrhythmic drugs while recovering. Usually, it takes about three months for the heart to heal completely.
Surgical Ablation
Surgical ablation uses heat or cold to stop faulty electrical signals in the heart. Unlike catheter ablation, this energy is applied directly during surgery. There is no need to thread catheters through the groin.
Surgical ablation is often done alongside other open-heart procedures. After surgery, patients typically stay in the ICU for monitoring. Then, they spend about a week in the hospital. After that, recovery takes several more weeks before they can return to work.
Hybrid Surgical/Catheter Ablation
Hybrid ablation uses both surgical and catheter techniques. It involves opening the chest. Then, electrode catheters go through blood vessels to reach the heart. Risks and recovery time differ between a standard catheter and full surgical ablation.
Repeat Catheter Ablation
For many patients, the first ablation successfully controls arrhythmias over the long term. If the condition returns after a few months, doctors might do a second catheter ablation. This helps to find and isolate the pulmonary veins that cause the irregular rhythm.
Pulmonary Vein Isolation
A past study on atrial fibrillation found that symptoms often returned. This was due to the reconnection of pulmonary veins. These veins carry oxygen-rich blood from the lungs to the heart.
Blocking the pulmonary veins and addressing other triggers in the atrial tissue can help prevent arrhythmia for a long time. This works for about three out of four patients who need a second ablation. The study suggested that more ablations past this point probably won’t help.
Risks of the Cardiac Ablation Procedure
Although heart ablation often stops arrhythmia, it carries certain risks. If you’re thinking about a second catheter ablation, weigh the benefits and risks
- Exposure to radiation during the catheter ablation procedure.
- Irregular heartbeat (arrhythmias), especially while the heart is healing.
- Blood clots can potentially cause a stroke or heart attack.
- Infection or bleeding at the puncture site.
- Damage to the vein in the groin from the sheath and catheter.
- Damage to the heart, including a puncture or damage to the valves.
- A narrowing of the pulmonary veins (pulmonary vein stenosis).
- Death (rare)
How to Reduce Your Risk of Recurrent Arrhythmias
Lowering your cardiac risk factors can reduce the chances of arrhythmia coming back:
- Treat heart failure and coronary artery disease (if present).
- Treat sleep-disordered breathing if it is present.
- Lose weight if you’re overweight.
- Lower high blood pressure.
- Eat a heart-healthy diet.
- Exercise regularly
- Stop smoking
- Reduce alcohol consumption.
- Reduce stress
- Check your cholesterol, blood pressure, and blood sugar annually.
- Take all heart medications as prescribed.
Heart medications, including antiarrhythmics, are only effective when taken exactly as prescribed. Helping them live healthier and change their diets can increase their impact. Over time, this may even improve or reverse heart conditions tied to arrhythmias.
Talk to your cardiologist when picking a treatment path. You may need to choose a procedure, change your medications, or adjust your diet and lifestyle.
FAQs
How many cardiac ablations can you have?
Not possible to remove the adverb. Still, many cardiologists believe their effectiveness falls after two or three procedures. If arrhythmias continue beyond that, doctors may recommend alternative treatments.
How soon can you have a second heart ablation?
Doctors may need to do a second heart ablation if the arrhythmia comes back months later. Patients usually wait at least three months. This time, let the heart heal completely before another ablation.
How many ablations can you have for atrial fibrillation?
Most patients do well after one or two ablations for atrial fibrillation. Success is higher when the pulmonary vein isolation works. If symptoms persist, extra procedures may be less effective and carry a higher risk.
How long is heart ablation surgery?
Heart ablation surgery usually lasts 2 to 4 hours. The case’s complexity and the number of abnormal signals affect the time. Recovery times vary based on the type of procedure performed.
What is the typical heart ablation surgery time and recovery period?
Heart ablation surgery takes a few hours under anesthesia. Afterward, you will stay in the hospital overnight. Most healthcare providers tell patients to rest for about a week. They expect a full recovery in three months.
Conclusion
Heart ablation works well for many arrhythmias. It often restores a normal rhythm in one or two procedures. Talk to your cardiologist before deciding on a repeat ablation. This is important, especially if your symptoms come back. Knowing how many ablations you can have is important. It’s also key to understand the usual surgery time and recovery period for heart ablation. This information helps you make better choices. You can improve your long-term health by combining medical treatment with lifestyle changes. This can also help reduce the chance of future arrhythmias.
