Fact Check: 9 Misconceptions About Ablations

Surgery fixes everything, right? Not always. While some surgeries have high success rates, others are relatively unpredictable. That is certainly the case with cardiac ablation, a surgical procedure used to treat arrhythmias like AFib. 

You might be surprised to learn that ablations are not as safe and successful as your doctor may have told you. We are here to reveal some major misconceptions about this increasingly popular cardiac surgery. 

What is cardiac ablation?

Cardiac ablation, also sometimes called catheter ablation, is a surgical procedure that aims to restore normal electrical function to a heart out of rhythm.

Typically performed by an interventional cardiologist, cardiac ablations use energy to make small scars in the heart tissue. Hypothetically, the new lesions in the heart block the abnormal pathway, thus restoring the heart’s normal rhythm. 

Approximately 360,000 people underwent cardiac ablations in the United States in 2020. Out of those, 240,000 were for AFib. 

Common misconceptions about cardiac ablations

Cardiac ablation is not major surgery 

Words like “minimally invasive” and “procedure” seem to indicate that cardiac ablation is not a big deal. However, any surgery done on the heart is significant, and a cardiac ablation is no exception. 

An ablation surgery takes anywhere from two to eight hours, depending on how successful the cardiologist is at finding the damaged cells of the heart. Cardiac ablations are typically performed by inserting one or more thin tubes called catheters through an incision in the groin. These catheters are guided to the heart and use cold (cryoablation) or heat (radiofrequency) to destroy or “ablate” heart tissue. 

In some instances, cardiac ablations are done surgically through the chest. These “maze procedures” are even more invasive surgeries. Similar to catheter ablations, cardiologists use heat or cold to destroy tissue. However, with a maze procedure, the goal is to redirect the electric impulses instead of simply eliminating tissue. 

Cardiac ablations have few side effects

Like any surgical procedure, cardiac ablations have side effects. Complications occur in the hospital for over six percent of those who have an ablation. Perhaps the most common complications in the days after surgery include other arrhythmias. 

Inflammation from the ablation leads to irritation in and around the heart, setting off more abnormal beats. Possible side effects are not always immediate either. A cardiac ablation requires that the doctor use a large amount of radiation during the procedure, which can cause long-term damage to the body. Other problems can include: 

  • Bleeding or infection at the surgical site
  • Damage of the phrenic nerve 
  • Blood clots or stroke 
  • Heart damage such as damaged valves or punctures
  • Heart attack 
  • Narrowing of the veins between the lungs and heart
  • Damaged blood vessels 

Cardiac ablations are entirely safe 

As with all surgeries of the heart, cardiac ablations are risky. Not only are there numerous possible side effects, but there is a risk of death from cardiac ablation. In fact, one out of every 200 people will die within 30 days of having a cardiac ablation. 

Cardiac ablation will fix your heart for good

The odds of an ablation fixing your heart aren’t promising. According to a 2015 study, cardiac ablations are approximately 50 percent successful. However, ten months after ablation, about 40 percent of people are back in AFib. Furthermore, three years after ablation, only 25 percent of people are free of arrhythmia. 

While some have success with cardiac ablations, they are hardly the long-term cure they are often portrayed as. Anywhere from 20-30 percent of ablation patients will need a second procedure due to a recurrence.

Many cardiac ablation patients want to know how long they will live after the surgery. Survival and quality of life after a cardiac ablation vary depending on the procedure’s success and other comorbidities. The healthier the patient going into a cardiac ablation, the more likely they will live a long life after the surgery. 

Cardiac ablations are the same for everyone

The success rate of a cardiac ablation depends on numerous factors, including what kind of AFib you have. Ablations are less likely to work for patients who have had AFib for an extended period. They are also less successful for women and those of advancing age. Individuals with heart failure, lung disease, and diabetes also have less success with ablations. 

Recovery is quick and easy

Recovery from cardiac ablation is different for everyone. For those who have a catheter ablation, the recovery is typically more straightforward. Patients need to lie flat for approximately six hours after surgery to prevent bleeding complications. Some patients may be able to go home that day. For surgical ablations, the recovery is much more extensive, requiring a longer hospital stay. 

For both procedures, it takes several weeks to gain stamina again. Because heart palpitations are common in the first few weeks, many individuals need to take it easy. It can take up to six months to feel back to baseline again. 

Diet doesn’t affect the outcome of cardiac ablations 

Food is medicine, and what you put in your body matters before a cardiac ablation and after. Diet has a significant impact on the success of cardiac ablation and the length of recovery. 

A 2020 study found that individuals who underwent a cardiac ablation and had non-alcoholic fatty liver disease (NAFLD) were much more likely to go back into AFib after ablation than those who had healthy livers. NAFLD is a condition where excess fat builds in the liver. While the exact cause of NAFLD is not known, it’s often seen in overweight individuals with poor diets. The study found 56 percent of patients with NAFLD had recurrent arrhythmia compared to 21 percent without the condition. 

In an even more recent randomized study, scientists concluded that losing weight improves outcomes for ablation patients. 

Sleep doesn’t affect the outcome of cardiac ablations

Sleep is vital for overall health, and it’s also essential for the heart. Sleep apnea is a significant risk factor for AFib, and it also impacts the outcome of cardiac ablations. Studies have demonstrated that individuals with sleep apnea have lower success rates with cardiac ablations than those who do not have the sleep condition. Additionally, the severity of the sleeping disorder impacts the success of the surgery. Those with more severe cases of obstructive sleep apnea (OSA) are less likely to find that ablations work for them. 

Stress doesn’t affect the outcome of ablations 

Our minds and bodies are inseparable and mental health is as important as physical health. Mindset going into a cardiac ablation can significantly impact healing. For example, studies have found that individuals with depression are more than twice as likely to have an AFib recurrence after a cardiac ablation. Therefore, eliminating stress and finding happiness is critical for normal heart rhythm. 

Next steps

There’s no doubt that cardiac ablations are a successful treatment option for some people, at least in the short term. However, it should only be a last resort after you’ve optimized your health through lifestyle changes. By striving to be the absolute best version of yourself before an ablation, you will have the best chance of success and could even restore normal heart rhythm without surgery. Before scheduling an ablation, speak with an expert practitioner here at Natural Heart Doctor. We’d love to help you find your 100 Year Heart.

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Medical Review 2022: Dr. Lauren Lattanza NMD

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