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When Your Child Needs Catheter Ablation

Catheter ablation is a way to treat a tachycardia. This is an abnormal heart rhythm (arrhythmia) in which the heart beats too fast. It is also called a tachyarrhythmia. Thin, flexible tubes (catheters) are put into the heart. The tissue that is causing the heart to beat too fast is then destroyed. This may be done with radio frequency (RF) waves. Or it may be done with cold temperature (cryoablation). The procedure takes about 2-6 hours. In most cases, it is done by an electrophysiologist. This is a doctor who is trained to treat electrical problems in the heart.  

Front view cross section of heart showing atria on top and ventricles on bottom and electrical system of heart. EPS catheter is inserted from vein into right atrium. Another EPS catheter is inserted in vein into right ventricle. Ablation catheter is inserted through vein into right atrium and is ablating part of atrial wall.

Before the Procedure

  • Tell the doctor if your child takes medications. Your child may need to stop taking them 3-5 days before the procedure.

  • Tell the doctor if your child has allergies.

  • Do not let your child eat or drink 4-6 hours before the procedure.

  • Follow all other instructions you are given.

During the Procedure

  • You will stay in a waiting area while the procedure is done.

  • Your child is given a sedative and pain reliever through an intravenous (IV) line. This will help your child relax and not feel pain. Anesthesia may also be used. This is given by a facemask or IV. A breathing tube may be placed in your child’s trachea (windpipe). Your child’s heart rate, oxygen levels, and blood pressure are watched.

  • The neck and/or groin are numbed with a local anesthetic. Small incisions are made. The catheters are then inserted through blood vessels.

  • The catheters are guided to the inside of the heart. X-ray pictures are used to help.

  • An electrophysiology study (EPS) is done. During this, the doctor tries to start the arrhythmia. An electrical map of the inside of the heart can then be created. This shows the type of tachycardia your child has. It also shows where in the heart the problem is located.

  • An ablation catheter is then moved to that area. RF energy or cold temperature is generated at the catheter tip. This destroys the problem cells. One or more of the following may be ablated:

  • An extra pathway of electrical tissue

  • Abnormal tissue that is making rapid electrical signals

  • A portion of the AV node. If this is done, a permanent pacemaker will be needed. This is a device that will take over the job of the AV node. It will direct the contractions (squeezing) of the chambers of the heart.

  • After the tissue is ablated, the doctor tries again to start up the arrhythmia. If it recurs, more tries with ablation may be needed.

  • When the procedure is done, the catheters are taken out of your child’s body. Pressure is applied to the insertion sites to help them close. No stitches are needed.

Girl riding bicycle.

After the Procedure

  • Your child is taken to a recovery room. You can join your child at this time. It may take 1-2 hours for the anesthesia to wear off.

  • Your child will need to lie flat for 2-6 hours. This is how long it takes for the insertion sites to close.

  • Your child may need to stay in the hospital for 1 or more nights.

  • Before your child leaves the hospital, you will be given instructions for home care. 

Follow-Up

A follow-up visit will be needed. This is to review the results of the procedure. You will be told if your child can stop taking heart rhythm medication. In many cases, one ablation is enough to treat a tachycardia. But the problem can return. Or another tachycardia can develop. Then your child may need a second catheter ablation. Tell the doctor if your child has new or returning symptoms.

Risks and Possible Complications of Catheter Ablation Include:

  • Bleeding or bruising at the catheter insertion sites

  • Blood clot

  • Infection

  • Return of the tachycardia

  • A slow heart rhythm (could require a permanent pacemaker)

  • Perforation of the heart muscle, blood vessel, or lung (may require emergency procedure)

  • Damage to heart valve (rare)

When to Call the Doctor

After the ablation procedure, call the doctor right away if your child has:

  • Increased bleeding, bruising, redness, or pain at the catheter insertion site(s)

  • Shortness of breath or chest pain

  • Coldness, swelling, or numbness of the arm or leg near the catheter insertion site(s)

  • A bruise or lump that’s larger than a walnut at the catheter insertion site(s)

  • A fever:

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

    • In a child of any age who has a temperature of 103°F (39.4°C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • A seizure caused by the fever

  • Palpitations (extra or skipped heartbeats)

  • Lightheadedness or syncope (fainting spells)

 

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