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Supraventricular Tachycardia: Should I Have Catheter Ablation?
You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Supraventricular Tachycardia: Should I Have Catheter Ablation?
1Get the |
2Compare |
3Your |
4Get the |
5Quiz |
6Your Summary |
Get the facts
Your options
- Have catheter ablation.
- Don’t have catheter ablation.
This decision is for adults who have supraventricular tachycardia (SVT).
Key points to remember
- Catheter ablation—a procedure that treats the heart rate problem called supraventricular tachycardia (SVT)—might be done if you have symptoms that bother you a lot and you do not want to take medicine, or medicine has not worked.
- Ablation works well to stop SVT.
- If the first ablation does not get rid of SVT, you may need to have it done a second time. A second ablation usually gets rid of SVT.
- Catheter ablation is considered safe. It has some serious risks, but they are rare.
What is catheter ablation?
Normally, your heart has a strong, steady beat. That beat is controlled by the heart’s electrical system. Sometimes that system does not work right, causing a heartbeat that is too fast. Supraventricular tachycardia (SVT) is one type of fast heart rate.
Catheter ablation is a way to get into your heart—without surgery—and fix the electrical problem. It’s like working on the spark plugs in your car without having to open the hood.
- It’s done in a hospital.
- The doctor inserts thin, flexible wires called catheters into a vein, usually in the groin or neck. Then the doctor threads the catheters up into your heart.
- X-rays and other images of the heart help the doctor see where to move the catheters.
- The catheters use extreme heat or cold to destroy the areas in your heart that are causing the electrical problem.
It may seem like a bad idea to destroy parts of your heart on purpose. But the areas that are destroyed are very tiny and don’t affect your heart’s ability to do its job.
When is catheter ablation done?
Catheter ablation might be done if you have symptoms that bother you a lot, you don’t want to take heart rhythm medicine, or medicine has not worked for you.
This treatment does have some serious risks, but they are rare. Many people decide to have ablation because they hope to feel much better afterward. That hope is worth the risks to them. But the risks may not be worth it for people who have few symptoms.
Certain people shouldn’t have ablation
Ablation isn’t a choice for some people, including those who:
- Aren’t able to lie still or cooperate with the doctor doing the test.
- Have a history of bleeding problems.
How well does catheter ablation work?
Catheter ablation works well to stop supraventricular tachycardia (SVT) and the symptoms it causes. How well it works can depend on the type of SVT. These success rates cover the more common SVT types called AVNRT (atrioventricular nodal reentrant tachycardia) and AVRT (atrioventricular reciprocating tachycardia).
Catheter ablation stops SVT in about 93 to 97 people out of 100.footnote 1, footnote 2 This means that ablation might not work for 3 to 7 people out of 100.
Sometimes, the first ablation does not get rid of SVT completely. SVT might come back in 5 to 8 people out of 100.footnote 1, footnote 2 This means that the problem might not come back in 92 to 95 people out of 100. A second ablation usually gets rid of SVT.
What are the risks?
Overall, problems might happen in about 3 people out of 100.footnote 1, footnote 2 This means that about 97 people out of 100 may not have problems. If problems happen during and soon after the procedure, your doctor is prepared to fix them right away.
Your risk of problems depends partly on the type of SVT that you have. Your doctor can help you understand your risk. He or she can also help you decide whether the possible benefits of ablation outweigh these risks:
- Problems might happen because of the catheter that was inserted in a vein. They include minor pain, bleeding, and bruising.
- Pacemaker placement. If there is damage to the heart’s electrical system during the procedure, you will need a pacemaker. This may happen in about 1 out of 100 people.footnote 1 This means that 99 out of 100 people may not need a pacemaker. With some types of SVT, where the abnormal cells are not close to the heart’s electrical system, there is a smaller risk of needing a pacemaker.
- Serious problems. Serious problems include heart attack, stroke, or damage to the heart. They are more likely with certain types of SVT. Your doctor can help you know your risk. Serious problems happen to less than 1 out of every 100 people.footnote 1 This means that more than 99 out of every 100 people do not have serious problems. Serious problems that might happen also include dangerous blood clots in the lungs.
- Death. Less than 1 out of every 100 people die during or soon after this procedure.footnote 1, footnote 2 This means that more than 99 out of every 100 people don’t die during or soon after the procedure.
The benefits may outweigh the risks if: |
The risks may outweigh the benefits if: |
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Compare your options
Compare
What is usually involved? |
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What are the benefits? |
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What are the risks and side effects? |
- The treatment is done in a hospital and takes 2 to 6 hours.
- You probably won’t be fully awake during the treatment. You may be lightly sedated or completely asleep.
- You may have some discomfort, either from having to lie still or from the ablation itself. Talk to your doctor if you are worried about this.
- Many people go home the same day.
- Many people feel a lot better after this treatment.
- If the treatment works, you won’t need heart rhythm medicines anymore.
- Ablation has serious risks. They include stroke and heart attack.
- About 1 out of 100 people might need a pacemaker after ablation.footnote 1
- If ablation doesn’t work the first time, you may have to have it done again.
- When you have an episode, you try vagal maneuvers, such as bearing down, to slow your heart rate.
- You try taking medicines to stop the abnormal heart rhythms.
- Vagal maneuvers and medicines relieve symptoms for some people.
- You don’t have to worry about the risks of ablation.
- You continue to have symptoms.
- Heart rhythm medicines may increase your risk of getting a more serious heart rate problem. You will need frequent checkups so your doctor can watch you closely while you take these medicines.
Personal stories about considering catheter ablation
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I started having episodes of really fast heartbeats 2 years ago. It’s this pounding in my chest—very scary. Medicines haven’t really helped. I hate the idea of having a procedure like this. But I’m more afraid of the pounding in my chest. I’m going to try catheter ablation.
Will, age 36
I know that catheter ablation usually works really well for my type of heart problem. But no one can guarantee that it’s completely safe. I’m not ready to take any more risks with my body. I’m going to keep using medicines to treat my fast heartbeat.
Juan, age 72
I don’t like the idea of taking the rhythm medicines. I would rather have the procedure and fix this problem for good.
Betty, age 57
I’m not really bothered by my symptoms when I have an episode. I can usually stop it with vagal maneuvers like coughing. For now, I don’t think I need to have this procedure.
Paula, age 48
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have catheter ablation
Reasons not to have catheter ablation
I’m not worried about having a procedure that involves my heart.
I’m very worried about having a procedure that involves my heart.
I’m bothered a lot by my symptoms.
My symptoms don’t bother me.
I don’t want to have to take a heart rhythm medicine.
I want to try medicine to relieve my symptoms.
The risks of ablation don’t bother me as much as the risks of taking medicine.
I prefer the risks of taking medicine over the risks of having catheter ablation.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having catheter ablation
NOT having catheter ablation
What else do you need to make your decision?
Check the facts
Decide what’s next
Certainty
1. How sure do you feel right now about your decision?
Your Summary
Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you’re leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
Author | Healthwise Staff |
---|---|
Primary Medical Reviewer | Adam Husney MD – Family Medicine |
Primary Medical Reviewer | Martin J. Gabica MD – Family Medicine |
Primary Medical Reviewer | E. Gregory Thompson MD – Internal Medicine |
Primary Medical Reviewer | Rakesh K. Pai MD, FACC – Cardiology, Electrophysiology |
- Calkins H, et al. (1999). Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. The Atakr Multicenter Investigators Group. Circulation, 99(2): 262–270. DOI:10.1161/01.CIR.99.2.262. Accessed January 19, 2016.
- Spector P, et al. (2009). Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. American Journal of Cardiology, 104(5): 671–677.
Supraventricular Tachycardia: Should I Have Catheter Ablation?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Have catheter ablation.
- Don’t have catheter ablation.
This decision is for adults who have supraventricular tachycardia (SVT).
Key points to remember
- Catheter ablation—a procedure that treats the heart rate problem called supraventricular tachycardia (SVT)—might be done if you have symptoms that bother you a lot and you do not want to take medicine, or medicine has not worked.
- Ablation works well to stop SVT.
- If the first ablation does not get rid of SVT, you may need to have it done a second time. A second ablation usually gets rid of SVT.
- Catheter ablation is considered safe. It has some serious risks, but they are rare.
What is catheter ablation?
Normally, your heart has a strong, steady beat. That beat is controlled by the heart’s electrical system. Sometimes that system does not work right, causing a heartbeat that is too fast. Supraventricular tachycardia (SVT) is one type of fast heart rate.
Catheter ablation is a way to get into your heart—without surgery—and fix the electrical problem. It’s like working on the spark plugs in your car without having to open the hood.
- It’s done in a hospital.
- The doctor inserts thin, flexible wires called catheters into a vein, usually in the groin or neck. Then the doctor threads the catheters up into your heart.
- X-rays and other images of the heart help the doctor see where to move the catheters.
- The catheters use extreme heat or cold to destroy the areas in your heart that are causing the electrical problem.
It may seem like a bad idea to destroy parts of your heart on purpose. But the areas that are destroyed are very tiny and don’t affect your heart’s ability to do its job.
When is catheter ablation done?
Catheter ablation might be done if you have symptoms that bother you a lot, you don’t want to take heart rhythm medicine, or medicine has not worked for you.
This treatment does have some serious risks, but they are rare. Many people decide to have ablation because they hope to feel much better afterward. That hope is worth the risks to them. But the risks may not be worth it for people who have few symptoms.
Certain people shouldn’t have ablation
Ablation isn’t a choice for some people, including those who:
- Aren’t able to lie still or cooperate with the doctor doing the test.
- Have a history of bleeding problems.
How well does catheter ablation work?
Catheter ablation works well to stop supraventricular tachycardia (SVT) and the symptoms it causes. How well it works can depend on the type of SVT. These success rates cover the more common SVT types called AVNRT (atrioventricular nodal reentrant tachycardia) and AVRT (atrioventricular reciprocating tachycardia).
Catheter ablation stops SVT in about 93 to 97 people out of 100.1, 2 This means that ablation might not work for 3 to 7 people out of 100.
Sometimes, the first ablation does not get rid of SVT completely. SVT might come back in 5 to 8 people out of 100.1, 2 This means that the problem might not come back in 92 to 95 people out of 100. A second ablation usually gets rid of SVT.
What are the risks?
Overall, problems might happen in about 3 people out of 100.1, 2 This means that about 97 people out of 100 may not have problems. If problems happen during and soon after the procedure, your doctor is prepared to fix them right away.
Your risk of problems depends partly on the type of SVT that you have. Your doctor can help you understand your risk. He or she can also help you decide whether the possible benefits of ablation outweigh these risks:
- Problems might happen because of the catheter that was inserted in a vein. They include minor pain, bleeding, and bruising.
- Pacemaker placement. If there is damage to the heart’s electrical system during the procedure, you will need a pacemaker. This may happen in about 1 out of 100 people.1 This means that 99 out of 100 people may not need a pacemaker. With some types of SVT, where the abnormal cells are not close to the heart’s electrical system, there is a smaller risk of needing a pacemaker.
- Serious problems. Serious problems include heart attack, stroke, or damage to the heart. They are more likely with certain types of SVT. Your doctor can help you know your risk. Serious problems happen to less than 1 out of every 100 people.1 This means that more than 99 out of every 100 people do not have serious problems. Serious problems that might happen also include dangerous blood clots in the lungs.
- Death. Less than 1 out of every 100 people die during or soon after this procedure.1, 2 This means that more than 99 out of every 100 people don’t die during or soon after the procedure.
The benefits may outweigh the risks if: |
The risks may outweigh the benefits if: |
|
|
2. Compare your options
Have catheter ablation | Don’t have catheter ablation | |
---|---|---|
What is usually involved? |
|
|
What are the benefits? |
|
|
What are the risks and side effects? |
|
|
Personal stories
Personal stories about considering catheter ablation
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
“I started having episodes of really fast heartbeats 2 years ago. It’s this pounding in my chest—very scary. Medicines haven’t really helped. I hate the idea of having a procedure like this. But I’m more afraid of the pounding in my chest. I’m going to try catheter ablation.”
— Will, age 36
“I know that catheter ablation usually works really well for my type of heart problem. But no one can guarantee that it’s completely safe. I’m not ready to take any more risks with my body. I’m going to keep using medicines to treat my fast heartbeat.”
— Juan, age 72
“I don’t like the idea of taking the rhythm medicines. I would rather have the procedure and fix this problem for good.”
— Betty, age 57
“I’m not really bothered by my symptoms when I have an episode. I can usually stop it with vagal maneuvers like coughing. For now, I don’t think I need to have this procedure.”
— Paula, age 48
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have catheter ablation
Reasons not to have catheter ablation
I’m not worried about having a procedure that involves my heart.
I’m very worried about having a procedure that involves my heart.
I’m bothered a lot by my symptoms.
My symptoms don’t bother me.
I don’t want to have to take a heart rhythm medicine.
I want to try medicine to relieve my symptoms.
The risks of ablation don’t bother me as much as the risks of taking medicine.
I prefer the risks of taking medicine over the risks of having catheter ablation.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having catheter ablation
NOT having catheter ablation
5. What else do you need to make your decision?
Check the facts
1. Does catheter ablation work well for supraventricular tachycardia (SVT)?
- Yes
- No
- I’m not sure
2. Is catheter ablation the only treatment to relieve symptoms of SVT?
- Yes
- No
- I’m not sure
3. If ablation doesn’t work the first time, can it be done again?
- Yes
- No
- I’m not sure
Decide what’s next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I’m ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
By | Healthwise Staff |
---|---|
Primary Medical Reviewer | Adam Husney MD – Family Medicine |
Primary Medical Reviewer | Martin J. Gabica MD – Family Medicine |
Primary Medical Reviewer | E. Gregory Thompson MD – Internal Medicine |
Primary Medical Reviewer | Rakesh K. Pai MD, FACC – Cardiology, Electrophysiology |
- Calkins H, et al. (1999). Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. The Atakr Multicenter Investigators Group. Circulation, 99(2): 262–270. DOI:10.1161/01.CIR.99.2.262. Accessed January 19, 2016.
- Spector P, et al. (2009). Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. American Journal of Cardiology, 104(5): 671–677.
Note: The “printer friendly” document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Current as of: April 9, 2019
Author: Healthwise Staff
Medical Review:Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & E. Gregory Thompson MD – Internal Medicine & Rakesh K. Pai MD, FACC – Cardiology, Electrophysiology