Catheter Ablation for PVCs: Restoring Normal Heart Rhythm
PVCs, or premature ventricular contractions, are heartbeats that originate in the lower chamber of your heart, which is also called the ventricles. These are extra heartbeats which are common and often harmless. However, excessive or frequent PVCs can lead to fatigue, palpitations, shortness of breath and reduced heart function (in some rare cases).
Catheter ablation for PVCs is considered the most effective and safest long-term treatment for persistent contractions.
What are Premature Ventricular Contractions
Your heart has a natural pacemaker—the sinoatrial node or SA node, where a normal heartbeat originates. Electrical impulses go through the upper chamber of the heart (atria) to the lower chamber of the heart (ventricles). This travel takes place in a coordinated sequence to ensure the heart pumps blood efficiently.
However, when electrical impulses begin from within the ventricles, PVCs occur. This “extra” heartbeat before the next normal beat. It is generally followed by a pause or more forceful heartbeat. Occasional PVCs are common and harmless, while frequent PVCs can cause:
-
Temporary drops in the blood flow, which lead to dizziness
-
Insufficient pumping, which leads to shortness of breath
A person can also feel uncomfortable palpitations, fatigue, and anxiety due to these reasons. In some rare cases of high PVC burden (more than 10-15% of total heartbeats), frequent premature ventricular contractions can weaken the heart muscle, which reduces the pumping efficiency. This is also called PVC-induced cardiomyopathy. Thus, PVC ablation is done to restore a healthy heartbeat.
Tests Done Before Catheter Ablation for PVCs
A medical team performs multiple tests on a patient before recommending cardiac ablation for PVCs. These are the common ones:
Important Things to Consider Before PVC Ablation
How Catheter Ablation for PVCs Works
A specialized cardiologist (electrophysiologist) performs cardiac ablation for PVC in an electrophysiology lab. It is done under general anesthesia or conscious sedation.
The common steps are:
-
The electrophysiologist inserts catheters, which are thin and flexible tubes, into the veins of the patient in either the arm, neck, or groin (most common). Catheters are then threaded to the heart with 3D mapping guidance.
-
An electrical mapping system helps in identifying the exact location where arrhythmias or abnormal heartbeats originate.
-
The identified area is considered the targeted area, and it is destroyed by either radiofrequency energy (applies extreme heat and cauterizes the affected tissue) or cryoablation (freezes the affected tissue).
-
Both of these methods leave a small scar that stops the faulty electrical signal.
-
After cardiac ablation for PVC, the doctor tries to trigger the premature ventricular contractions to ensure the source of arrhythmias has been treated successfully.
-
At last, the doctor removes the catheters from the patient’s body. And the patient is kept under observation for several hours.
Recovery After Premature Ventricular Contractions Ablation
As catheter ablation for PVCs is a minimally invasive procedure, the recovery is fast. Generally, patients are allowed to go home the same day or the next morning. Here are a few things doctors advise after ablation:
-
Patients are suggested to resume light activities after 24 hours and to avoid rigorous physical activities, including heavy exercises, for a week.
-
Some patients may have to continue medications for a short span to stabilize their heart rhythm.
-
Routine checkups become important after a certain period of PVC ablation. They may include Holter monitoring and ECGs.
FAQs
Is cardiac MRI necessary for PVC ablation?
It is not always mandatory; however, in some cases, doctors may recommend a cardiac MRI.
Does it hurt while getting a catheter ablation for PVCs?
No, it is a minimally invasive procedure done under general anesthesia or conscious sedation. Hence, the patient does not feel any pain during the ablation.
What if I feel uneasy after the ablation procedure?
It is normal to feel skipped beats in the initial week. They get restored after the tissue heals completely. However, if you feel skipped beats too frequently, extreme fatigue, or any other unusual symptoms, consult your doctor.
What are the common side effects of catheter ablation for PVCs?
Some common and harmless aftereffects are as follows:
-
Mild soreness at the catheter site
-
Light bruising at the catheter site
-
Feeling a skipped heartbeat
If you feel any of the above at a moderate level, you are normal. These aftereffects heal on their own.
But if the intensity of these effects is high, consult your doctor.
