Ventricular Tachycardia (VT) Ablation

Ventricular tachycardia (VT) is a type of abnormal heart rhythm that happens when the lower chambers of the heart (ventricles) beat too fast to pump blood effectively, so the body doesn’t receive enough oxygenated blood. Despite medicines, catheter ablation for VT may be required to complement the treatment of this potentially life-threatening fast heartbeat.

VT ablation is a catheter-based procedure that targets the abnormal heart tissue responsible for the fast heart rhythm. Ablation is usually offered to people whose VT cannot be treated by medication alone. Also, some patients who have an implantable cardioverter defibrillator (ICD) may need a VT ablation to eliminate or reduce the number of shocks they get from their ICD.

• Before VT ablation, follow all instructions, including medication instructions, 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 arrival time.
• During VT 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. Some patients may need an arterial line for continuous blood pressure monitoring. Patients will receive 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 your groin and guide the catheter to your 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), extreme cold (cryoablation), or pulse field ablation is applied to destroy the abnormal tissue causing the VT.
  Catheter ablation for VT takes approximately three to five hours.
• After the VT ablation, you’ll be moved to a recovery room or to the cardiac ICU to be monitored and receive any necessary post-procedure treatment. 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.

What Are Risks Associated With VT Ablation?

Most people who undergo VT 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 VT, 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

Your provider will let you know when you will be able to return to your normal activities and 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 a few 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.