Your ablation may be performed at a hospital as a day-case (this means you arrive and leave on the same day) but usually you will be expected to stay one night in hospital. You will be admitted to hospital approximately 2 hours before your procedure is due. A nurse will prepare you for the procedure. You will be mildly sedated and lying completely flat on your back. Your blood pressure and ECG will be monitored continuously during the test. The procedure is performed in an X-ray room and can take anywhere from 1-4 hours.
During an ablation, a small, plastic catheter (tube) is inserted through a vein in the groin (or arm, in some cases) and is threaded into the heart, under X-ray guidance. Once in the heart, electrical signals are sent through the catheter to the heart tissue to evaluate the electrical conduction system contained within the heart muscle tissue.
The figure below shows the standard positions of catheters in the procedure as seen under fluoroscopy (X-rays) and a sample of the intracardiac electrograms at the different sites.
The test is performed through the blood vessels at the top of the leg and occasionally under the collar bone near the shoulder. You will receive an injection of local anaesthetic to numb the area, so it should not be too painful. Once numb, a fine plastic tube (catheter) will be inserted into the blood vessel and through this several fine wires are passed into the blood vessel.
The wires are moved through your blood vessels into the correct position in the heart. You will be able to watch the procedure on the TV screens if you wish. Once the catheter(s) are placed properly, the electrical testing will begin by sending very small electrical impulses to certain areas within the heart. You may begin to feel lightheaded or dizzy at this stage particularly if the tachycardia is triggered. The tachycardia may be treated either by giving you medication or by stimulating the heart in a different position with the wires.
When the area of tissue causing your tachycardia is located (the "short-circuit"), the ablation is performed to eliminate the tissue. This is done with radio waves (radiofrequency ablation). The radio waves are delivered through the catheter to the tissue. If you notice any discomfort or pain, such as chest pain, neck or jaw pain, back pain, arm pain, shortness of breath, or breathing difficulty, let the doctor know.
Once the procedure has been completed, the catheter(s) will be removed. The puncture in the blood vessels will be sealed by gentle pressure.