Fluctuations in your heartbeat can be normal—say, when you’re exercising or sleeping. But certain heart conditions, including atrial fibrillation (AFib), cause irregular heartbeats (otherwise known as arrhythmias) that aren’t normal. And if left untreated, arrhythmias can lead to cardiac arrest, heart failure or stroke.
Cardiac ablation is a minimally invasive surgical procedure that uses heat or cold energy to destroy a small area of heart tissue that is causing those arrhythmias. The goal is to block irregular electrical signals and restore the heart’s regular rhythm.
“Medications may sometimes be effective but are associated with long-term side effects and risks,” explains Brett Gidney, M.D., an electrophysiologist at UCLA Health. “Most patients would choose an ablation procedure if they have access to a cardiac electrophysiologist.” In fact, a study published in a 2023 issue of Heart Rhythm O2 found that patients who underwent cardiac ablation had a 57% lower risk of developing heart failure than those receiving anti-arrhythmic drugs.
How the procedure works
With cardiac ablation, sometimes called catheter ablation, a small flexible tube (a.k.a. catheter) is inserted into a vein in the groin and guided through the veins and/or arteries up into the heart. There, the location of the abnormal tissue that’s responsible for the arrhythmia is identified.
Biosense Webster’s CARTO™ 3D Mapping System allows electrophysiologists to identify the abnormal tissue by generating a 3D electroanatomic map of the heart chambers and navigate safely around them in real time.
“Integrated mapping has been a cornerstone of cardiac ablation over the years because it can help identify appropriate treatment pathways to tailor the procedure to each patient,” says Anthony Hong, Vice President, Global Strategic Marketing, at Biosense Webster, a Johnson & Johnson MedTech company.
Once the problem area is identified, the abnormal heart tissue is destroyed using either radiofrequency ablation (extreme heat) or cryoablation (extreme cold). The resulting scar tissue blocks the abnormal electrical signals and restores a normal heartbeat.
Choosing whether to use radiofrequency ablation or cryoablation depends on a number of factors, including the specific characteristics of a patient’s AFib, the availability of the technologies and the preferences and experience level of the electrophysiologist, says Dr. Gidney. Research shows that, overall, the two procedures are comparable in their effectiveness.
The healing and recovery process is very easy, and most people are back to their normal activities within 48 hours.
Dr. Gidney explains that cardiac ablation procedures typically take 30 minutes to two hours, and most patients are able to go home the same day. “The healing and recovery process is very easy, and most people are back to their normal activities within 48 hours.”
Currently in clinical development at Biosense Webster is Pulsed Field Ablation (PFA) technology, which uses a controlled electric field to ablate cardiac tissue. PFA has the potential to offer safe, consistent and efficient therapy for patients. Because the energy does not rely on thermal effects to destroy targeted tissue, PFA offers the potential to minimize injury to the surrounding tissue. Among the potential benefits for both patients and physicians: PFA shaves time off the procedure and potentially reduces the risk of damage to the esophagus, veins and nerves that exists with other ablation techniques.
