Purpose of Ablation Surgery

An ablation surgery is a type of procedure to remove or reprogram tissue in the body that is damaged or causing interference. The most common type of ablation is a cardiac ablation, where bits of tissue that disrupt electrical signals in the heart are destroyed with an energy pulse.

Other types of ablation procedures are used to treat problems in the bladder, uterus, and even the brain. Keep reading to find out what conditions might require you to need an ablation procedure.

Diagnosis Related to Ablation Surgery

There are several conditions that might lead you to need an ablation surgery. In this section, you will learn about conditions associated with the different kinds of ablation surgeries. There are other types of ablation, but these are the most common.

Within each of the types below, there are a number of indications and contraindications to the procedure. Your doctor will counsel you based on your individual condition and risk factors.

Cardiac Ablation

Cardiac ablation is usually used to treat a number of types of arrhythmia—abnormal heart rhythms. The heart beats to a certain program, or rhythm. When this rhythm is disrupted, you may suffer a number of complications—some even fatal.

During an ablation, a catheter is inserted into your heart, and various energies are used to reprogram your heart rhythm—ideally correcting the problem. Some of the most common diagnoses that require cardiac ablation include:

• Atrial flutter
• Atrial fibrillation
• Atrial tachycardia
• Ventricular tachycardia
• Premature ventricular contractions

Endometrial Ablation

Endometrial ablation is a minimally invasive way to treat abnormal uterine bleeding or severe cramping. During endometrial ablation, the ablation device is inserted into the uterine cavity, and energy is used to destroy the lining of the uterus.

For this reason, pregnancy is not possible after ablation, since the egg would not be able to implant into the uterine lining. There are a number of contraindications for this procedure, including cancer and the desire to become pregnant in the future.

Endovenous Ablation

There are a number of conditions that can cause your blood vessels to become backed up, causing painful bulges, cosmetic blemishes, and even circulation problems. Endovenous ablation uses heat energy to close off problematic veins that cause blood in the veins to back up or pool—mostly in the legs.

This is primarily a cosmetic procedure, but can be used is some cases to improve blood flow. Common diagnoses for this procedure include:

• Chronic venous insufficiency
• Varicose veins
• Symptomatic saphenous vein reflux

Bladder ablation

Ablation surgery can also be used to treat a number of conditions that block the flow of urine. A catheter is inserted and energy is used to clear the obstruction for a number of conditions.

In adult males, the prostate may block the flow of urine. In male infants there can be excess valves the disrupt the flow of urine and need to be removed (posterior urethral valves).

Outside of an enlarged prostate (benign prostatic hyperplasia) and posterior urethral valves, bladder ablation may also be used to treat some non-muscular bladder cancers.

Ablative Brain Surgery

Ablative brain surgery is used for a number of neurologic conditions. Advances in medications and other therapies have decreased the use of ablation in neurology conditions, but it is still used in some cases—particularly where medication and other therapies have failed to bring relief.

Neurological diagnoses that have been treated by ablation include:

• Movement disorders like Parkinson’s disease
• Seizures and epileptic conditions that don't respond to medications
• Tremors
• Chronic pain
• Psychiatric disorders like major depressive disorder
• Brain tumors

Criteria

The decision to use ablation to correct or treat a certain condition will be made by you and your doctor. Typically, medications are used first, and ablation is used when these medications are contraindicated or do not work. Criteria for ablation is specific to the condition you are trying to treat.

Cardiac ablations are the most common, and criteria for cardiac ablation generally is used when medications don’t work or are not tolerated to treat conditions like:

• Atrioventricular reentrant tachycardia (AVRT) associated with the Wolff-Parkinson-White (WPW) syndrome or a concealed accessory pathway
• AV nodal reentrant tachycardia (AVNRT)
• Atrial tachycardia
• Atrial flutter
• Atrial fibrillation
• Frequent ventricular ectopy
• Ventricular tachycardia (VT)
• Persistent, frequent, or unstoppable tachycardia
• Triggering premature ventricular contractions (PVCs) in people with polymorphic VT and ventricular fibrillation
• Unifocal (or ectopic) atrial tachycardia
• Sinoatrial node reentrant tachycardia (SNRT)
• Intraatrial reentrant tachycardia (IART)
• Inappropriate sinus tachycardia (IST), or chronic nonparoxysmal sinus tachycardia

There are some situations where, in spite of having any one of these conditions, that you might not be a candidate for an ablation. Cardiac ablation may contraindicated for an number of reasons, as well, including:

• Unstable angina, or chest pain
• Bacteremia or sepsis
• Acute decompensated congestive heart failure
• Major bleeding disorders
• Some blood clotting disorders
• Cardiac masses or clots

For other types of ablation, your doctor may require that you meet certain criteria to undergo the procedure.

Tests and Labs

Depending on the reason for your ablation surgery, a number of tests and studies will be required before the day of surgery. Most of these tests are designed to identify and pinpoint the specific area for treatment, and to try and prevent complications—like bleeding problems—after the procedure.

In cardiac ablation, specifically, your doctor will likely order the following tests.

• Cardiac mapping using electrophysiologic (EP) testing
• Cardiac magnetic resonance imaging (MRI) or computed tomography (CT)
• Transesophageal echocardiogram (TEE)
• Electrocardiogram (ECG)
• Echocardiogram (echo)
• Holter monitor test

Your doctor may also order blood testing to check your blood chemistry and clotting factors. These tests will happen in the weeks or days before your ablation surgery.

For other types of ablation surgeries, your doctor will check blood work and various types of imaging studies. In some cases—like with venous problems—a physical assessment may be enough to diagnose your condition and plan for surgery. In all cases, your doctor will perform a general physical assessment and review your health history before your surgery.

A Word From Verywell

Ablation is a surgery used to reprogram areas of the heart or brain, or to clear blockages. Energy is directed at the affected area during ablation surgery, which can be used to treat a condition or even cure it altogether.

While an ablation is generally a minimally invasive procedure in comparison to other treatments, this surgery still comes with significant risks. Be sure to discuss your risks versus the benefits of the procedure with your doctor.