Ablation: What to Expect on the Day of the Procedure

An ablation is technically a minimally invasive surgical procedure. Your experience on the day of your procedure will depend a lot on the type of ablation you will have and how well your body handles it.

Ablation can be done on an outpatient basis. For more delicate ablations—like a cardiac ablation—your healthcare provider may want to keep you overnight for observation.

This article looks at some common types of ablation and how they work. It takes a step-by-step approach on what you can expect, including potential complications.

Before an Ablation

Before the ablation procedure, your healthcare provider will run a number of tests. These are used to view the affected part of the body and identify areas that need to be repaired or removed. You also may have blood work done to make sure you are healthy enough to have the ablation.

By the day of your procedure, your healthcare provider should have all the information they need. The next step will be to get you prepared for the procedure. This may include the following steps:

• Your nurse will take your vital signs. These include blood pressure, heart rate, temperature, and oxygen level.
• You will be placed on a machine to monitor these vital signs during your procedure.
• You'll be asked a pre-screening checklist of questions, including about your medical history and any implanted devices.
• You'll remove any metal objects, such as jewelry.
• A nurse or other provider will place an intravenous (IV) line for any drugs you will need during the procedure.
• You may receive IV fluids, especially with a cardiac ablation.
• Your nurse may insert a urinary catheter to collect and monitor your urine output.
• Your skin will be prepped for the ablation catheter. For a cardiac ablation, this means the groin area will be shaved and cleansed.

When you and your healthcare provider are ready to begin, you will be moved to another room and placed on a special table. It is outfitted with X-ray or magnetic resonance imaging (MRI) tools. These tools guide your practitioner with real-time images as the ablation is performed.

For some ablation procedures, notably those for the skin, your medical professional may simply be able to see the area without needing other tools.

During an Ablation

The technique and process for your ablation will vary a lot depending on the part of the body where your ablation is being done. Usually, the hollow ablation catheter is inserted, and your healthcare provider will use the imaging devices to find the problem area.

Electrical impulses, fluids, or other methods are then used to remove, destroy, or "reprogram" the tissue that is causing the problem. Below, you will find the steps of two types of ablation procedures. They are cardiac ablation and endometrial ablation.

Cardiac Ablation

You may experience these steps:

• Once you are placed on the operating table, you will be given medicine to help you relax. You may even have general anesthesia that puts you to sleep for the rest of the procedure.
• When the drug has taken effect, your healthcare provider will use a drug to numb the site where the catheter goes in. There may be a slight sense of burning as the numbing agent begins to work.
• The catheter usually goes into the groin for a cardiac ablation, but your practitioner may also use blood vessels in the arm or neck.
• Tubing—or a sheath—is then placed into the blood vessel the medical professional is using. A small catheter and wires are threaded through the tubing until it reaches your heart.
• Your healthcare provider will use a type of X-ray called fluoroscopy to see the inside of your heart and the location of the tools used in the procedure.
• The catheter and imaging tools are used to find abnormal heart signals, called arrhythmias.
• The heart areas sending these abnormal signals are mapped by computer, and energy is sent through the catheter to target them.
• This energy heats or freezes the affected tissue. It causes a lesion, about one-fifth of an inch across, that stops the abnormal signals from going through this tissue in the future.
• If you are awake, you may feel some discomfort during the ablation. It may seem like your heart is speeding up or slowing down throughout the procedure.
• If you are awake and feeling pain, tell your healthcare provider. You should avoid taking deep breaths or moving as the practitioner works.
• Once the ablation is over, the medical team will perform a few tests. They also may use certain drugs to make sure your heart does not continue to send the arrhythmia signals.
• If your medical professional is satisfied with the results, the catheter will come out. The site will be closed with a dressing or surgical adhesive.
• In most cases, pressure is applied to the site in order to prevent bleeding.
• You will be taken to a recovery area where you will be asked to lie fairly still. You may be there anywhere from one to six hours as healthcare providers monitor your vital signs.
• The procedure should take between three and eight hours.

Endometrial Ablation 

An endometrial ablation is less invasive than the cardiac type, but the purpose is still the same: Energy (or some other force) is used to destroy the problem tissue. Compare the steps of a cardiac ablation to an endometrial ablation below:

• As with a cardiac ablation, you will be taken to a room equipped for the procedure.
• You will be given medicine to help you relax. You might also receive general anesthesia or an epidural for the procedure.
• You will be placed as you would for a pelvic exam. A speculum will be inserted into the vagina to help your healthcare provider reach the cervix.
• Your cervix will be cleaned using an antiseptic solution, and the practitioner will make an opening in the cervix using small rods.
• A tool called a hysteroscope will be inserted through the opening and into the uterus.
• Your medical professional will feed the catheter and ablation tools through the hysteroscope.
• The uterus may be filled with a liquid or gas to help your healthcare provider see the inside of it.
• The type of energy used to destroy the endometrium will vary based on the method your practitioner has chosen. You may feel some cramping as the ablation is performed.
• The entire ablation procedure only takes about 10 minutes. After it's done, you will go to a recovery area until any anesthesia wears off.
• If you did not have anesthesia, your healthcare provider will still want to monitor you for about two hours.

After an Ablation

After your ablation procedure, your medical team will watch for any continued problems or issues. For more invasive procedures, like a cardiac ablation, you will likely stay at least overnight but up to a few days in the hospital for observation.

For less invasive procedures, you can usually leave the same day. That's likely within hours of an endometrial ablation, or just minutes after more superficial procedures.

For cardiac ablation, some of the major complications of concern include:

• An abnormal heart rhythm that continues
• New heart problems or abnormal rhythms
• Problems related to anesthesia
• Bleeding from the catheter insertion site, or from the site of the ablation
• Infection
• Blood clots

With an endometrial ablation, your healthcare provider will watch for excessive bleeding or other issues. Some bleeding and discharge are normal for at least several days after your ablation.

If you stay overnight in the hospital, you will likely be moved to a regular hospital room. If you go home the same day, you will most likely be discharged directly from the recovery area.

You should have someone with you to drive you home after your ablation, and your healthcare provider will give you instructions about follow-up care and visits.

Summary

There are differences in ablation techniques and procedures, but the goal is the same: Abnormal tissue is destroyed to prevent further problems. In many cases, the ablation is done on an outpatient basis and, barring any issues, you will be headed home in a few hours. Procedures involving sensitive areas, such as the heart or brain, may require a hospital stay.

A Word From Verywell

The idea of having an ablation (or any procedure, for that matter) may cause anxiety. That's especially true if you've not had one before and don't really know what to expect. Ask your healthcare provider to review the plan with you before the day of your procedure. That way you'll know exactly what to expect, and you'll arrive at your appointment with confidence.