Radiofrequency ablation is a procedure to cure rapid heart rhythms (tachycardia) in the heart. Abnormal electrical pathways in the heart (short circuits) are usually the cause.  

This procedure is very similar to an electrophysiological study (EPS), which is performed beforehand.

The procedure

The doctor inserts three or more temporary pacing wires, normally through your groin into a vein.

Each wire is guided to the heart under x?ray control and positioned at the required site. Once in position, each wire is connected to the monitoring equipment.

You will undergo a repeat of the EPS to map the characteristics of your heart's electrical conduction system. Having gathered the information the doctor will trigger the tachycardia (rapid heart beat). By doing this, the exact site of the accessory pathway (short-circuit) will be established.

Once the site is isolated, high-frequency energy is applied to the tip of the electrode of the wire positioned at the site of the accessory pathway (origin of the short-circuit). Radiofrequency ablation is then used to cauterise the accessory pathway (short-circuit). It may often be necessary to reposition the pacing wire several times to eliminate the short-circuit successfully.

If it appears that the ablation was successful, the doctor will wait a prescribed time before attempting to trigger the tachycardia again. If it restarts, the doctor will reposition the wire once more and deliver further radiofrequency energy to ablate the pathway. This process is repeated until the short-circuit has been ablated. The procedure is successful when the tachycardia is unable to be re-started.

Sometimes the pathway is not accessible for this procedure because it is too deep, or lies on the outside of the heart. The doctor will then consider other options for management of your tachycardia.

Reference

Thompson, P. L. (ed). Coronary Care Manual. London: Churchill–Livingstone, 1997, pp. 192–193.

This information was first published in You and Your Heart - an education booklet for patients, families and friends. © 2006 Northern Sydney Central Coast Area Health Service