How Successful Is Supraventricular Tachycardia (SVT) Ablation?
Medically reviewed by Richard N. Fogoros, MD
Supraventricular tachycardia (SVT) ablation is a procedure used to prevent recurrent cardiac arrhythmias in people who have SVT.
SVT is a family of cardiac arrhythmias that originate in the upper chambers of the heart (the atria)—including atrial tachycardia, atrial fibrillation, atrial flutter, atrioventricular nodal reentrant tachycardia (AVNRT), and Wolff-Parkinson-White syndrome. These arrhythmias are generally not life-threatening, but often cause palpitations, weakness, light-headedness, fatigue, shortness of breath, and—in the case of atrial fibrillation—can increase the risk of stroke.
SVT ablation is a first-line treatment for SVT. It restores a normal heartbeat by killing the tissue causing the rapid heartbeat.
SVT ablation can be used for people who do not respond well to drugs for the heart. It can also treat those who can't take these drugs or want to avoid them and the risk of side effects.
This article describes SVT ablation goals, risks, methods, and outlook. It also describes what to expect during and after your treatment.
Goal of SVT Ablation Procedure
The goal of SVT ablation procedure is to restore a normal heart rhythm to those with SVT. This is accomplished by hindering the cells that send signals that trigger a rapid heartbeat and interfere with your heart's ability to produce a normal rhythm.
While medication can decrease the frequency of tachycardia events, these drugs don't work for everyone. Taking them can also put you at risk for side effects.
The purpose of SVT ablation procedure is to create tiny scars in your heart to block the abnormal signals interfering with a regular heartbeat. A successful SVT ablation procedure can provide a long-term or permanent solution for people with SVT. This can achieve the following goals:
Prevent episodes of rapid heartbeat
Relieve symptoms of rapid heartbeat such as dizziness, chest pain, or fainting
Prevent problems caused by the condition
SVT Ablation Risks
SVT ablation is performed by cardiac electrophysiologists, cardiologists who specialize in managing cardiac arrhythmias. The procedure is generally regarded as very safe and effective. Research indicates that rare complications occur in 0.3% to 2.5% of procedures.
The risk of complications is highest in older people and those with multiple morbidities (the presence of two or more chronic health conditions).
The most common risk of ablation is bleeding and oozing from your veins at the site of the catheter insertions. This can usually be controlled with pressure on the site.
SVT ablation carries a 1% or less risk of the following serious complications:
Heart attack caused by the procedure
Stroke due to a blood clot that forms during the procedure
Damage to the heart or lungs that requires another surgery
Puncture of the heart
Death
Catheter Insertion for SVT Ablation
SVT ablation is a type of cardiac ablation. Cardiac ablation uses a metal-tipped catheter, or a narrow plastic tube about 2–3 millimeter (mm) in diameter, to kill the cells that cause irregular electrical signals to your heart.
The catheters are inserted into a vein through one or more punctures, typically in your groin or neck. Then the catheters are threaded up through the vein and into your heart. While you may feel some pressure, you shouldn't feel pain.
Fluoroscopy, an imaging technique that shows internal organs in motion, helps your cardiologist move the catheter through the vein.
The metal tips are electrodes that record the electrical signals from the heart. This helps identify the areas causing the irregular electrical signals. Your cardiologist creates a GPS-like map of the electrical activity in your heart to identify the sites that require ablation.
Ablation eliminates the source of your tachycardia without damaging your normal cardiac function.
SVT Ablation Techniques
SVT ablation techniques are minimally invasive procedures that allow your cardiologist to access your heart without major surgery. These techniques are used to destroy the tiny areas of heart tissue that are responsible for causing the arrhythmia.
SVT ablation techniques typically take three to four hours to complete. They are usually performed in a hospital.
The type of SVT ablation technique you receive depends on the type and severity of your condition. Other factors, including your age, other chronic health conditions, and the expertise of your cardiologist, can affect the type of procedure used.
Techniques vary in the process used to destroy the targeted tissue. These methods include the following:
Radiofrequency ablation: Uses high-energy radiofrequency signals that apply heat to destroy the tissue causing the arrhythmia
Cryoablation: Uses extremely cold temperatures to ablate or destroy the tissue causing the arrhythmia
SVT Ablation Post-Op Instructions
Your cardiologist will provide SVT ablation post-op instructions individualized for your condition and the type of procedure performed. Immediately after the procedure, you will have to stay in bed for five or six hours so the hospital staff can monitor your heart rhythms.
While it is common practice to remain in the hospital overnight for observation after SVT ablation, it is feasible for some patients to go home the same day.
SVT ablation post-op instructions help you carefully return to your normal activities. The following general guidelines are typically part of SVT ablation post-op instructions as you recover from SVT ablation:
Do not drive for at least two days.
Do not lift more than 10 pounds for one week.
Do not exercise for one week.
Do not have sex for one week.
Start walking on the evening of your procedure.
Keep the incision site clean and dry.
Typically, you may return to work within three or four days as long as your duties do not involve strenuous exertion or heavy lifting.
Possible Complications Following SVT Ablation
While serious complications following SVT ablation are rare, there is a possibility that you may experience one of the following problems:
Blood vessel damage
Blood clots
Damage to your heart valve or heart muscle
Damage to your heart's electrical system, which could worsen your condition or require that you have a pacemaker implanted
Kidney damage
Pulmonary stenosis (narrowing of the pulmonary valve)
Development of new arrhythmias
When to Seek Emergency Care
Call 911 or seek emergency medical care if you have any of the following symptoms after SVT ablation:
Fast swelling of the puncture site
Bleeding from the puncture site that does not slow down when pressure is applied
Pain or discomfort in your chest that moves into your jaw, neck, or arm
Drooping face, arm weakness, difficulty speaking
Recovery Period for SVT Ablation
The recovery period for SVT ablation varies by individual. Age and other chronic medical conditions can affect how your body heals.
The ablated areas of tissue inside your heart may take up to eight weeks to heal. In the first few weeks after SVT ablation, you may experience the following symptoms:
Irregular heartbeat
Mild chest aches or discomfort
Heart palpitations, including fast or skipping heartbeat
Bruising at the catheter site, which can involve a black-and-blue appearance
Research indicates that people who have this procedure report a high rate of satisfaction with regard to symptom treatment. In a study group of people treated with SVT ablation, 74.1% perceived the treatment as successful, 15.7% said it was partly successful and only 9.6% thought their procedure was unsuccessful.
Does SVT Return After Ablation?
The initial success rate of SVT ablation is more than 90%. Research indicates that ablation stops SVT in about 93 to 97 people out of 100. That means that ablation may not work for 3% to 7% of people treated. The success rate for ablating atrial fibrillation is somewhat lower than for other types of SVT, in the range of about 75% to 80%.
SVT returns in 5% to 8% of people treated with SVT ablation. People who have a second SVT ablation typically have better results, with successful treatment of the SVT.
With a low recurrence rate and low rate of complications, the prognosis for people who have SBT ablation is generally good. Research indicates that the majority of people treated with SVT ablation achieve significant symptomatic improvement. However, the risk of recurrence of SVT exists as long as five years after ablation-induced correction.
Monitoring Heart Rhythm After SVT Ablation
After SVT ablation, you will likely return to your cardiologist's office for a follow-up appointment about two to four weeks after your procedure. This is an opportunity to discuss any lingering symptoms after your procedure.
Before your appointment, you will likely receive a Holter monitor. This is a type of ambulatory electrocardiographic (ECG) monitoring. It is usually worn for up to seven days.
During that time, it records an ECG so your cardiologist can determine whether you are having an irregular heartbeat by reviewing the results. Holter monitoring may also be repeated at three, six, and 12 months after your procedure.
Depending on your condition, you may also have to attend additional office visits with your cardiologist or have more tests to monitor your heart rate.
Summary
SVT ablation can safely correct supraventricular tachycardia (SVT), a cause of rapid heartbeat. This treatment blocks faulty electrical signals from reaching the upper chambers of your heart. These bad signals can cause your heart to beat too fast.
SVT ablation is used as first-line therapy or after heart drugs fail. In either case, it can often resolve the problem of a fast heartbeat with a low risk of complications.
This treatment may be a good choice if you have SVT but can't take heart drugs or don't want to deal with the risks of side effects. Most cases of SVT can be fixed with a single treatment. Those treated have a good long-term outlook.
