Radiofrequency ablation, often called catheter ablation or cardiac ablation, is a procedure that treats certain abnormal heart rhythms by targeting the small area of heart tissue that sends or carries the faulty electrical signals. A cardiac electrophysiologist, a cardiologist who specializes in the heart's electrical system, guides thin, flexible tubes called catheters through a blood vessel into the heart, finds the problem spot, and applies energy to it. The treated tissue forms a tiny scar that no longer conducts the abnormal signal, and the heart can return to a normal rhythm.
Many people who hear about ablation have been living with palpitations, a racing heart that starts and stops suddenly, or atrial fibrillation that medication has not controlled well. For the right patient, ablation can reduce or end those episodes and sometimes reduce the need for daily rhythm medication. It is still an invasive heart procedure, though, and it is one option among several rather than the automatic next step.
NYMD Center does not perform ablation. What we do is the work that comes before and after it: finding out what your rhythm problem actually is, treating triggers and underlying causes, starting medication when it makes sense, and referring you to an electrophysiologist when ablation is worth considering. We then stay involved, co-managing your care before the procedure and during recovery.
Which rhythm problems ablation treats
Ablation is used for rhythm problems that come from a specific area or pathway in the heart. According to the American Heart Association, it is used most often for supraventricular tachycardia (SVT), and also for atrial flutter and atrial fibrillation. Mayo Clinic adds that it can treat some cases of ventricular tachycardia and frequent premature ventricular contractions (PVCs).
SVT is a regular, fast rhythm that often switches on and off abruptly, sometimes in young and otherwise healthy people. Atrial flutter is an organized fast rhythm in the upper chambers that usually travels around a predictable circuit. Atrial fibrillation (AFib) is a chaotic, irregular rhythm in the upper chambers that causes palpitations, fatigue and breathlessness and raises the risk of stroke. People typically become candidates for ablation when symptoms continue despite medication, when medication causes side effects they cannot tolerate, or when they prefer not to take rhythm drugs long term. For a broader look at palpitations and irregular rhythms, see our page on changes in heart rhythm.
How we evaluate rhythm problems at NYMD Center
A good referral starts with a clear diagnosis. We begin with a detailed history: what the episodes feel like, how often they happen, how long they last, whether they start suddenly, and whether they come with dizziness, fainting, chest pain or shortness of breath. We review caffeine, alcohol, sleep, supplements and medications, and we examine your heart and check your blood pressure.
An ECG (EKG) is done in our office and identifies the rhythm if it is present at the time. Because many rhythm problems come and go, an ambulatory ECG monitor worn during normal life is often the key test for capturing an episode and matching it to your symptoms. Blood work checks thyroid function, potassium, magnesium and kidney function, since an overactive thyroid or an electrolyte problem can drive a rhythm disturbance on its own. When the structure and pumping of the heart need to be checked, we arrange an echocardiogram and review the results with you.
Treatment options, least invasive first
Treating triggers and underlying causes
Some rhythm problems settle once their cause is treated. Cutting back on caffeine and alcohol, stopping smoking and stimulants, treating sleep apnea, correcting a thyroid or electrolyte problem, and controlling blood pressure and weight can reduce episodes, particularly of atrial fibrillation. For SVT, simple vagal maneuvers such as bearing down can sometimes stop an episode. These steps carry no procedural risk but do not cure a rhythm that comes from an extra electrical pathway.
Medication
Rate-control medications such as beta blockers or calcium channel blockers slow a fast heartbeat, and antiarrhythmic drugs aim to keep a normal rhythm. Medication avoids a procedure but has to be taken every day, may cause fatigue, dizziness or low blood pressure, and some rhythm drugs can themselves cause rhythm problems; the National Heart, Lung, and Blood Institute notes that a dose that is too high can make an arrhythmia worse. For people with atrial fibrillation, the decision about a blood thinner to lower stroke risk is separate from rhythm treatment and applies whether or not you have an ablation.
Catheter ablation by referral
When ablation is a good option, we refer you to a cardiac electrophysiologist. The procedure is done in a hospital electrophysiology lab. Catheters are passed through a blood vessel, usually in the groin, and the specialist maps the heart's electrical signals to locate the source of the problem. The tissue is then treated with one of several energy types: radiofrequency, which uses controlled heat; cryoablation, which uses extreme cold; or pulsed field ablation, which uses short electrical pulses. Mayo Clinic notes the procedure often takes about 3 to 6 hours. Some people go home the same day and others stay overnight.
The trade-offs are real. Possible complications listed by the American Heart Association and Mayo Clinic include bleeding or infection at the catheter site, blood clots, damage to a blood vessel or the heart, new rhythm problems, and, rarely, stroke or fluid around the heart that needs urgent treatment. The chance that one procedure solves the problem differs by rhythm type, and some people need a repeat ablation. Your electrophysiologist will give you an estimate that fits your rhythm and your heart.
Recovery after ablation
Most people are back to daily activities within a few days. The American Heart Association advises avoiding driving, heavy activity, lifting more than 10 pounds and soaking the catheter site for about a week. Mild soreness or bruising where the catheter went in is common. Some people notice palpitations or extra beats for a while as the treated area heals, and that does not necessarily mean the procedure failed. Blood thinners and rhythm medications are often continued for a period afterward according to the electrophysiologist's plan, and we help you manage them alongside your other medications.
What to expect at your visit
At your first visit we take your history, examine you and record an ECG. Bring your medication and supplement list, any smartwatch tracings or home readings, and prior ECGs, monitor reports or hospital records. If your symptoms come and go, we will likely arrange a wearable monitor. When ablation is on the table, we explain why, make the referral, and send your records ahead so the specialist has the full picture. Before the procedure we can review your medications, including blood thinners and diabetes medicines, and arrange pre-procedure labs. Afterward, we see you back to check your rhythm, review your medications and follow up on the results with you. You can read more about how we coordinate heart care on our cardiology page.
When to seek care urgently
Call 911 for a racing or irregular heartbeat with fainting or near-fainting, chest pain or significant shortness of breath, or for any stroke symptoms such as facial droop, one-sided weakness or numbness, or trouble speaking. After an ablation, seek care promptly for bleeding or swelling at the catheter site that does not stop with firm pressure, fever, worsening chest pain, or shortness of breath.
Questions patients ask
Does NYMD Center perform radiofrequency ablation?
No. Ablation is performed in a hospital electrophysiology lab by a cardiac electrophysiologist. Our physicians evaluate your rhythm problem with an office ECG, ambulatory monitoring and labs, arrange an echocardiogram when needed, treat triggers and prescribe medication, and refer you for ablation when it makes sense. We continue to co-manage your care before and after the procedure.
Which heart rhythm problems can ablation treat?
Ablation is used most often for supraventricular tachycardia (SVT) and is also used for atrial flutter and atrial fibrillation. Some cases of ventricular tachycardia and frequent premature ventricular contractions can also be treated. Whether it is a good choice depends on the exact rhythm, how much it affects you, and how well medication has worked.
How long does ablation take and when can I go back to normal activities?
Mayo Clinic notes the procedure often takes about 3 to 6 hours. Some people go home the same day and others stay overnight. Most return to daily activities within a few days, but you should avoid heavy lifting, strenuous activity and soaking the catheter site for about a week, following your electrophysiologist's instructions.
What are the risks of catheter ablation?
Possible complications include bleeding, bruising or infection where the catheter went in, blood clots, damage to a blood vessel or the heart, new rhythm problems, and, rarely, stroke or fluid around the heart that needs urgent treatment. Your electrophysiologist will explain your individual risk and the likely chance of success for your specific rhythm.
Is ablation better than taking medication?
It depends on the rhythm and on you. Medication avoids a procedure but must be taken daily and can cause side effects. Ablation can reduce or end episodes for some rhythms, particularly SVT, but it carries procedural risks and sometimes needs to be repeated. We help you weigh both options before any referral.