Premature Ventricular Contraction Ablation

What Is Premature Ventricular Contraction Ablation?

Premature ventricular contractions (PVCs) are extra heartbeats that occur in one of the heart’s two lower chambers (ventricles). The extra beats disrupt the regular heart rhythm and can cause the sensation of fluttering, skipped heartbeat or a “pause” followed by a more forceful heartbeat. Although usually harmless, PVCs can cause symptoms such as dizziness, shortness of breath, palpitations, and even heart failure in some people.

PVC ablation is a procedure performed to eliminate or reduce the frequency of PVCs if lifestyle changes and medication have not helped to reduce and manage symptoms.

• Before PVC ablation, follow all instructions, including medications, as indicated by your provider. Certain medications may need to be stopped before your procedure. Please contact your provider to discuss any questions or concerns about the current medications you are taking. Do not eat or drink anything after midnight before your procedure, with the exception of water. You may drink water up to two hours before your scheduled arrival time, unless otherwise instructed. The hospital will notify you the day before your procedure to confirm your admission and fasting times.
• During PVC ablation, you will be closely monitored to assess your vital signs, heart rhythm, your body’s response to sedation and any arrhythmias. An IV will be placed in one of your arms so that your care team can give you medicine during the procedure. Most patients are given medications for pain and conscious sedation. Some patients may need general anesthesia, which is medication that puts you in a sleep-like state.
  Your doctor will insert a long, flexible tube (catheter) into a blood vessel through the groin and guide the catheter to the heart, without cutting your skin. Sensors at the tip of the catheter will receive electrical signals from your heart that help your doctor identify abnormal heart rhythm. Once the critical area is located, heat (radiofrequency ablation) or extreme cold (cryoablation) is applied to destroy a small area containing the abnormal tissue causing PVCs.
  PVC ablation takes approximately two to three hours.
• After PVC ablation, you’ll be moved to a recovery room where you’ll be monitored for a few hours. Following the procedure, you may have some bruising and discomfort at the groin area. When it’s time to be discharged from the hospital, you’ll be given detailed instructions about at-home care. Most patients are sent home two to three hours after the procedure. If needed, you may spend a night in the hospital.

What Are the Risks Associated With Premature Ventricular Contraction Ablation?

Most people who undergo PVC ablation and other cardiac ablation procedures do not experience complications. Potential complications include:

• Vascular damage/bleeding: During insertion of the catheter, damage to your blood vessels can occur that may result in bleeding. Manual pressure, pressure dressings, bed rest, or rarely, surgery may be needed to stop the bleeding.
• Rapid abnormal heart rhythm: The procedure could cause you to pass out for a very short period of time. In some cases, a small electric shock may be needed to restore a normal heart rhythm.
• Cardiac perforation: Rarely, the procedure can result in an unintended puncture to the heart chamber or heart valve.
• Heart block: Depending on the type and location of the PVC, there’s a slight chance of heart block occurring, which is when the heartbeat signal has trouble moving from the upper to lower parts of the heart. This could be temporary, but permanent damage would require implantation of a pacemaker at the time of the procedure.
• Blood clots, stroke and heart attack: Major complications such as stroke, heart attack and death are very rare. Blood thinners (anticoagulants) are used during the ablation procedure to prevent blood clotting that could lead to stroke.

Recovery & Outlook

You should be able to return to your normal activities the day after you go home. Your provider will let you know when it’s safe to resume physically demanding activity and driving. If your job does not involve heavy lifting or other physical labor, you should be able to return to work two to three days after your ablation procedure.

To prevent the formation of harmful blood clots, you’ll be required to take anticoagulant medicine for at least a short time after your procedure.

Complete healing from your ablation may take several weeks. During this time, you may continue to have arrhythmias while your heart tissue heals. This is normal. You’ll have follow-up visits with your provider, usually for a year after your procedure. If your symptoms return, you may need to have another ablation or a different procedure to correct your abnormal heart rhythm.