Cardioneural Ablation

What are the Goals of the Cardioneural Ablation Procedure?

To treat the recurring sudden drops in heart rate that causes a person to faint. 

What are the risks of Cardioneural Ablation?

Cardiac ablation is a minimally invasive procedure performed to treat certain cardiac arrhythmias (abnormal heart rhythms). Here are some potential risks associated with cardiac ablation procedures in general: 

• Bleeding: During the procedure, there is a risk of bleeding, either at the site where catheters are inserted or internally within the heart. 
• Infection: Infections can occur at the site where catheters are inserted. Although rare, they can potentially lead to serious complications. 
• Blood vessel damage: The catheters used in the procedure can cause injury to blood vessels, which can result in bleeding, hematoma (a collection of blood outside blood vessels), or vascular complications. 
• Arrhythmia exacerbation or new arrhythmias: In some cases, cardiac ablation may worsen existing arrhythmias or create new ones. This can be due to inadvertent damage to normal heart tissue during the procedure. 
• Pericardial effusion: Occasionally, the ablation procedure can cause fluid accumulation in the pericardial sac (pericardial effusion), which may need to be drained if it becomes significant. 
• Damage to adjacent structures: There is a small risk of damaging nearby structures, such as the esophagus, nerves, or coronary arteries, during the ablation procedure. 
• Blood clots or stroke: The formation of blood clots in the heart or catheters is a potential risk. If a clot dislodges and travels to the brain, it can cause a stroke. 
• Radiation exposure: Cardiac ablation procedures often involve the use of fluoroscopy, a type of X-ray imaging, which exposes the patient and healthcare professionals to some radiation. However, the doses used are typically low and within safe limits. 

It’s important to note that the risks and potential complications associated with any medical procedure can vary depending on the individual case. Your provider will discuss risks with you at your visit. 

Why Should I have the Cardiac Ablation Procedure with South Denver Cardiology?

Dr. Dan Alyesh  and Dr. Sri Sundaram , routinely perform ablations. Our center has consistently maintained a lower rate of complications compared to the average rate seen in the literature. While this procedure is relatively new, both Dr Sundaram and Dr Alyesh have the most experience with this procedure in Colorado.  

Our group has been at the forefront of publishing in this space. Here is a link to a couple of our papers: 

• Procedural and short-term results of electroanatomic-mapping-guided ganglionated plexus ablation by first-time operators: A multicenter study
• Largest Ablation Registry of Its Kind Reveals Potential Treatment Option for Common Fainting Condition

What happens during the procedure? 

Cardioneural Ablation is a way to help people with certain heart problems. It uses a technique called radiofrequency ablation to treat the parts of the nervous system that affect the heart. This involves using special tools to remove or disrupt the connections between the nerves and the heart in areas called ganglia. By doing this, doctors hope to reduce the influence of the parasympathetic autonomic system, which can cause problems for some patients. 

Where is it done? 

The procedure is done in an Electrophysiology Lab at Porter Adventist Hospital or Swedish Medical Center. 

How long does it take? 

Approximately 2-3 hours 

What type of anesthesia is used?

General anesthesia or moderate sedation  

What happens right after the procedure?

Should I anticipate same-day discharge or staying the night?   

Typically, you get to go home the same day. If the procedure is later in the day or if there are concerns post-procedure, you will stay overnight. 

After a cardioneural ablation procedure, the specific feelings and experiences can vary from person to person. However, here are some common experiences and sensations that patients may typically encounter during the recovery period: 

• Soreness and discomfort: You may experience some soreness, bruising, or tenderness at the catheter insertion site, typically in the groin area. This discomfort should subside gradually over a few days. 
• Fatigue: Feeling tired or experiencing fatigue is common after a cardiac ablation. The body needs time to recover from the procedure and adjust to the changes made in the heart’s electrical system. It’s important to get adequate rest during this time. 
• Irregular heart rhythm: You may initially experience episodes of irregular heart rhythm or palpitations after the procedure. This is a normal part of the healing process, as the heart adjusts to the changes made during the ablation.  

• Chest discomfort: Some individuals may have mild chest discomfort or tightness for a few days following the procedure. This is generally a result of the healing process and should gradually improve. 
• Medication adjustments: Your doctor may prescribe medications to manage symptoms or prevent blood clots after the ablation. It’s essential to take any prescribed medications as directed and report any side effects or concerns to your doctor. 
• Improved heart rhythm: In many cases, patients experience a significant improvement in their heart rhythm following the ablation procedure.  

It’s important to follow the specific aftercare instructions provided by your medical team. This may include restrictions on physical activities, avoiding certain medications, and scheduling follow-up appointments to monitor your progress. 

Remember that everyone’s experience can differ, and it’s essential to communicate any concerns or unusual symptoms to your healthcare provider. They will be able to provide personalized guidance and support throughout your recovery. 

What is my expected recovery course? 

You can drive 24 hours after your procedure.  However, you may be sore and may want to wait longer to drive, especially long distances.  After an ablation, the activity restrictions aim to prevent groin incision bleeding. Any activities that involve a lot of movement in the groin region or those that increase pressure in the abdomen will also put pressure on the blood vessels where the incision(s) were made. Therefore, during the first 4-7 days after the ablation, avoid heavy lifting (more than 10 lbs), straining during bowel movements, excessive bending over, stooping, walking long distances, running, or climbing many flights of stairs. You may resume normal activity 1 week after the ablation.  It takes 3 months for the heart cells to heal after an ablation to know if the procedure was successful.  

Note on Pre-Op and Post-Op instructions:  The most up-to-date pre- and post-operative instructions will be the ones provided to you during your pre-op visit & on your hospital DC instructions given to you when checking-out of the hospital.