Ablation is a procedure that is aimed at correcting an abnormal heart rhythm—or an arrhythmia. It’s a procedure that’s done through the blood vessels in your leg, sometimes the neck, where we put special wires called catheters into the child’s heart. These wires carry the information about the electrical system of the heart back to a mapping system—or a series of computers—and we create a picture of the electrical system of the heart.

Once we understand the electrical system of the child’s heart we can usually invoke the abnormal heart rhythm (the arrhythmia). Once we have reproduced the arrhythmia we then use a specialized catheter that has the ability to either heat or freeze the abnormal tissue, ablating the arrhythmia.

Arrhythmias are much more common in adults, but young people also get arrhythmias. And these arrhythmias can be treated sometimes with medication, but the cure is an ablation to get rid of the problem. Most children that undergo ablation, it’s usually a family decision. It’s based on what the arrhythmia is, how bothersome it is, is it interfering with the child’s life? Perhaps it’s interfering with the ability to do sports, or participate in normal recreational activities.

Sometimes ablation is chosen because of side effects of medication or the desire to be medication-free. Ablation is usually done at a specialized hospital in a specialized laboratory using sometimes x-ray, but usually some form of imaging equipment. Ablation is done as an outpatient procedure usually; most children don’t have to stay overnight in the hospital.

Ablation carries a very high success rate: over 95 percent for some types of arrhythmia, with a very low complication rate. When your doctor discusses ablation with you, they’re likely to mention some of these complications—many of which sound quite serious, and many of which are very serious. But they’re all very uncommon.

The recovery after an ablation is usually quite quick, and children are usually discharged on the same day. There are usually guidelines about return to activity and return to school. Sometimes a medication is prescribed for a short period after an ablation.

In a small group of patients, the arrhythmia can come back. In this case, the tissue hasn’t been destroyed, but it’s only been temporarily injured, and the child may develop the same symptoms again. In this case a second procedure might be necessary.

An ablation is usually only offered to a child who is known to have an arrhythmia. A child with heart rhythm problem or an arrhythmia may present with what are called palpitations, a sensation that the heartbeat is very fast, or an abnormal heartbeat. In some cases a child may have episodes of sudden poor energy, breathing difficulty or chest discomfort. These can be due to heart rhythm problems—or arrhythmias—at times.

Prior to being considered for an ablation, the child will have undergone confirmation that there is an arrhythmia, some baseline investigations, possibly even treatment strategies before choosing an ablation.

Ablation is a safe procedure with a very high success rate that’s usually done as a day procedure. It’s important to consider ablation as a potential cure if your child is suffering from an arrhythmia. If you have any further questions about ablation, or heart arrhythmias, please discuss these with your physician.

Presenter: Dr. Shubhayan Sanatani, Cardiologist, Vancouver, BC

Now Health Network Local Practitioners: Cardiologist