Merck Manual

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Destroying Abnormal Heart Tissue (Ablation)

By

L. Brent Mitchell

, MD, Libin Cardiovascular Institute of Alberta, University of Calgary

Full review/revision Jan 2023
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There are many causes of abnormal heart rhythms Causes Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more Causes (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle, such as avoiding alcohol, caffeine (in beverages and foods), and smoking. Other arrhythmias are dangerous or bothersome enough to need treatment. Ablation is one type of treatment. Other treatments for arrhythmias include insertion of a pacemaker Artificial Pacemakers There are many causes of abnormal heart rhythms (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle,... read more Artificial Pacemakers or an implantable cardioverter-defibrillator (ICD) Implantable Cardioverter-Defibrillator (ICD) There are many causes of abnormal heart rhythms (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle,... read more , cardioversion-defibrillation Cardioversion-Defibrillation There are many causes of abnormal heart rhythms (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle,... read more Cardioversion-Defibrillation , or use of antiarrhythmic drugs Drugs to Treat Abnormal Heart Rhythms There are many causes of abnormal heart rhythms (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle,... read more .

Certain types of arrhythmias are due to a localized abnormal area in the heart’s electrical system. Destroying or removing that area (ablation) can sometimes eliminate the arrhythmia.

Most often, the abnormal area is destroyed by radiofrequency ablation (delivery of energy of a specific frequency through a catheter with a tiny electrode at its tip that is inserted into the heart). Ablation may also be done by freezing tissue (called cryoablation), destroying tissue with a laser (laser ablation), or by applying short bursts of high voltage electrical energy (called pulsed electrical field ablation).

Less commonly, the area is destroyed or removed during open heart surgery. Sometimes surgery is needed because catheter-based ablation was not effective. Other times, surgery is used because people are having heart surgery for another reason, such as to replace a heart valve.

Radiofrequency Ablation
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