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Supraventricular Tachycardia: Should I Have Catheter Ablation?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Non-Interactive Decision Point

Supraventricular Tachycardia: Should I Have Catheter Ablation?

Get the facts

Your options

  • Have catheter ablation.
  • Don't have catheter ablation.

This decision is for adults who have supraventricular tachycardia (SVT).

Key points to remember

  • Catheter ablation-a procedure that treats the heart rate problem called supraventricular tachycardia (SVT)-might be done if you have symptoms that bother you a lot and you do not want to take medicine, or medicine has not worked.
  • Ablation works well to stop SVT.
  • If the first ablation does not get rid of SVT, you may need to have it done a second time. A second ablation usually gets rid of SVT.
  • Catheter ablation is considered safe. It has some serious risks, but they are rare.
FAQs

What is catheter ablation?

Normally, your heart has a strong, steady beat. That beat is controlled by the heart's electrical system. Sometimes that system does not work right, causing a heartbeat that is too fast. Supraventricular tachycardia (SVT) is one type of fast heart rate.

Catheter ablation is a way to get into your heart-without surgery-and fix the electrical problem. It's like working on the spark plugs in your car without having to open the hood.

  • It's done in a hospital.
  • The doctor inserts thin, flexible wires called catheters into a vein, usually in the groin or neck. Then the doctor threads the catheters up into your heart.
  • X-rays and other images of the heart help the doctor see where to move the catheters.
  • The catheters use extreme heat or cold to destroy the areas in your heart that are causing the electrical problem.

It may seem like a bad idea to destroy parts of your heart on purpose. But the areas that are destroyed are very tiny and don't affect your heart's ability to do its job.

When is catheter ablation done?

Catheter ablation might be done if you have symptoms that bother you a lot, you don't want to take heart rhythm medicine, or medicine has not worked for you.

This treatment does have some serious risks, but they are rare. Many people decide to have ablation because they hope to feel much better afterward. That hope is worth the risks to them. But the risks may not be worth it for people who have few symptoms.

Certain people shouldn't have ablation

Ablation isn't a choice for some people, including those who:

  • Aren't able to lie still or cooperate with the doctor doing the test.
  • Have a history of bleeding problems.

How well does catheter ablation work?

Catheter ablation works well to stop supraventricular tachycardia (SVT) and the symptoms it causes. How well it works can depend on the type of SVT. These success rates cover the more common SVT types called AVNRT (atrioventricular nodal reentrant tachycardia) and AVRT (atrioventricular reciprocating tachycardia).

Catheter ablation stops SVT in about 93 to 97 people out of 100.footnote 1, footnote 2 This means that ablation might not work for 3 to 7 people out of 100.

Sometimes, the first ablation does not get rid of SVT completely. SVT might come back in 5 to 8 people out of 100.footnote 1, footnote 2 This means that the problem might not come back in 92 to 95 people out of 100. A second ablation usually gets rid of SVT.

What are the risks?

Overall, problems might happen in about 3 people out of 100.footnote 1, footnote 2 This means that about 97 people out of 100 may not have problems. If problems happen during and soon after the procedure, your doctor is prepared to fix them right away.

Your risk of problems depends partly on the type of SVT that you have. Your doctor can help you understand your risk. He or she can also help you decide whether the possible benefits of ablation outweigh these risks:

  • Problems might happen because of the catheter that was inserted in a vein. They include minor pain, bleeding, and bruising.
  • Pacemaker placement. If there is damage to the heart's electrical system during the procedure, you will need a pacemaker. This may happen in about 1 out of 100 people.footnote 1 This means that 99 out of 100 people may not need a pacemaker. With some types of SVT, where the abnormal cells are not close to the heart's electrical system, there is a smaller risk of needing a pacemaker.
  • Serious problems. Serious problems include heart attack, stroke, or damage to the heart. They are more likely with certain types of SVT. Your doctor can help you know your risk. Serious problems happen to less than 1 out of every 100 people.footnote 1 This means that more than 99 out of every 100 people do not have serious problems. Serious problems that might happen also include dangerous blood clots in the lungs.
  • Death. Less than 1 out of every 100 people die during or soon after this procedure.footnote 1, footnote 2 This means that more than 99 out of every 100 people don't die during or soon after the procedure.
Weighing the risks and benefits of catheter ablation

The benefits may outweigh the risks if:

The risks may outweigh the benefits if:

  • You have symptoms that bother you a lot.
  • You don't want to take heart rhythm medicines.
  • Heart rhythm medicines aren't helping.
  • Medicines help, but their side effects bother you a lot.
  • You can't take the medicines because of other health problems.
  • You have only mild symptoms that don't really bother you.
  • You prefer to try heart rhythm medicines.
  • You aren't bothered by side effects of heart rhythm medicines.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Have catheter ablation Have catheter ablation
  • The treatment is done in a hospital and takes 2 to 6 hours.
  • You probably won't be fully awake during the treatment. You may be lightly sedated or completely asleep.
  • You may have some discomfort, either from having to lie still or from the ablation itself. Talk to your doctor if you are worried about this.
  • Many people go home the same day.
  • Many people feel a lot better after this treatment.
  • If the treatment works, you won't need heart rhythm medicines anymore.
  • Ablation has serious risks. They include stroke and heart attack.
  • About 1 out of 100 people might need a pacemaker after ablation.footnote 1
  • If ablation doesn't work the first time, you may have to have it done again.
Don't have catheter ablation Don't have catheter ablation
  • When you have an episode, you try vagal maneuvers, such as bearing down, to slow your heart rate.
  • You try taking medicines to stop the abnormal heart rhythms.
  • Vagal maneuvers and medicines relieve symptoms for some people.
  • You don't have to worry about the risks of ablation.
  • You continue to have symptoms.
  • Heart rhythm medicines may increase your risk of getting a more serious heart rate problem. You will need frequent checkups so your doctor can watch you closely while you take these medicines.

Personal stories about considering catheter ablation

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I started having episodes of really fast heartbeats 2 years ago. It's this pounding in my chest-very scary. Medicines haven't really helped. I hate the idea of having a procedure like this. But I'm more afraid of the pounding in my chest. I'm going to try catheter ablation.

Will, age 36

I know that catheter ablation usually works really well for my type of heart problem. But no one can guarantee that it's completely safe. I'm not ready to take any more risks with my body. I'm going to keep using medicines to treat my fast heartbeat.

Juan, age 72

I don't like the idea of taking the rhythm medicines. I would rather have the procedure and fix this problem for good.

Betty, age 57

I'm not really bothered by my symptoms when I have an episode. I can usually stop it with vagal maneuvers like coughing. For now, I don't think I need to have this procedure.

Paula, age 48

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have catheter ablation

Reasons not to have catheter ablation

I'm not worried about having a procedure that involves my heart.

I'm very worried about having a procedure that involves my heart.

More important
Equally important
More important

I'm bothered a lot by my symptoms.

My symptoms don't bother me.

More important
Equally important
More important

I don't want to have to take a heart rhythm medicine.

I want to try medicine to relieve my symptoms.

More important
Equally important
More important

The risks of ablation don't bother me as much as the risks of taking medicine.

I prefer the risks of taking medicine over the risks of having catheter ablation.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having catheter ablation

NOT having catheter ablation

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Does catheter ablation work well for supraventricular tachycardia (SVT)?
2, Is catheter ablation the only treatment to relieve symptoms of SVT?
3, If ablation doesn't work the first time, can it be done again?

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
2, Check what you need to do before you make this decision.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

What matters to you 

Print Summary

Credits and References

Credits
AuthorHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Primary Medical ReviewerMartin J. Gabica, MD - Family Medicine
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
References
Citations
  1. Calkins H, et al. (1999). Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. The Atakr Multicenter Investigators Group. Circulation, 99(2): 262-270. DOI:10.1161/01.CIR.99.2.262. Accessed January 19, 2016.
  2. Spector P, et al. (2009). Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. American Journal of Cardiology, 104(5): 671-677.
Other Works Consulted
  • Calkins H (2011). Supraventricular tachycardia: Atrioventricular nodal reentry and Wolf-Parkinson-White syndrome. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 1, pp. 987-1005. New York: McGraw-Hill.
  • Miller JM, Zipes DP (2015). Therapy for cardiac arrhythmias. In DL Mann et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th ed., vol. 1, pp. 685-720. Philadelphia: Saunders.
  • Olgin JE, Zipes DP (2015). Specific arrhythmias: Diagnosis and treatment. In DL Mann et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th ed., vol. 1, pp. 748-797. Philadelphia: Saunders.
  • Page RL, et al. (2015). 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. DOI: 10.1161/CIR.0000000000000311. Accessed September 23, 2015.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Supraventricular Tachycardia: Should I Have Catheter Ablation?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Have catheter ablation.
  • Don't have catheter ablation.

This decision is for adults who have supraventricular tachycardia (SVT).

Key points to remember

  • Catheter ablation-a procedure that treats the heart rate problem called supraventricular tachycardia (SVT)-might be done if you have symptoms that bother you a lot and you do not want to take medicine, or medicine has not worked.
  • Ablation works well to stop SVT.
  • If the first ablation does not get rid of SVT, you may need to have it done a second time. A second ablation usually gets rid of SVT.
  • Catheter ablation is considered safe. It has some serious risks, but they are rare.
FAQs

What is catheter ablation?

Normally, your heart has a strong, steady beat. That beat is controlled by the heart's electrical system. Sometimes that system does not work right, causing a heartbeat that is too fast. Supraventricular tachycardia (SVT) is one type of fast heart rate.

Catheter ablation is a way to get into your heart-without surgery-and fix the electrical problem. It's like working on the spark plugs in your car without having to open the hood.

  • It's done in a hospital.
  • The doctor inserts thin, flexible wires called catheters into a vein, usually in the groin or neck. Then the doctor threads the catheters up into your heart.
  • X-rays and other images of the heart help the doctor see where to move the catheters.
  • The catheters use extreme heat or cold to destroy the areas in your heart that are causing the electrical problem.

It may seem like a bad idea to destroy parts of your heart on purpose. But the areas that are destroyed are very tiny and don't affect your heart's ability to do its job.

When is catheter ablation done?

Catheter ablation might be done if you have symptoms that bother you a lot, you don't want to take heart rhythm medicine, or medicine has not worked for you.

This treatment does have some serious risks, but they are rare. Many people decide to have ablation because they hope to feel much better afterward. That hope is worth the risks to them. But the risks may not be worth it for people who have few symptoms.

Certain people shouldn't have ablation

Ablation isn't a choice for some people, including those who:

  • Aren't able to lie still or cooperate with the doctor doing the test.
  • Have a history of bleeding problems.

How well does catheter ablation work?

Catheter ablation works well to stop supraventricular tachycardia (SVT) and the symptoms it causes. How well it works can depend on the type of SVT. These success rates cover the more common SVT types called AVNRT (atrioventricular nodal reentrant tachycardia) and AVRT (atrioventricular reciprocating tachycardia).

Catheter ablation stops SVT in about 93 to 97 people out of 100.1, 2 This means that ablation might not work for 3 to 7 people out of 100.

Sometimes, the first ablation does not get rid of SVT completely. SVT might come back in 5 to 8 people out of 100.1, 2 This means that the problem might not come back in 92 to 95 people out of 100. A second ablation usually gets rid of SVT.

What are the risks?

Overall, problems might happen in about 3 people out of 100.1, 2 This means that about 97 people out of 100 may not have problems. If problems happen during and soon after the procedure, your doctor is prepared to fix them right away.

Your risk of problems depends partly on the type of SVT that you have. Your doctor can help you understand your risk. He or she can also help you decide whether the possible benefits of ablation outweigh these risks:

  • Problems might happen because of the catheter that was inserted in a vein. They include minor pain, bleeding, and bruising.
  • Pacemaker placement. If there is damage to the heart's electrical system during the procedure, you will need a pacemaker. This may happen in about 1 out of 100 people.1 This means that 99 out of 100 people may not need a pacemaker. With some types of SVT, where the abnormal cells are not close to the heart's electrical system, there is a smaller risk of needing a pacemaker.
  • Serious problems. Serious problems include heart attack, stroke, or damage to the heart. They are more likely with certain types of SVT. Your doctor can help you know your risk. Serious problems happen to less than 1 out of every 100 people.1 This means that more than 99 out of every 100 people do not have serious problems. Serious problems that might happen also include dangerous blood clots in the lungs.
  • Death. Less than 1 out of every 100 people die during or soon after this procedure.1, 2 This means that more than 99 out of every 100 people don't die during or soon after the procedure.
Weighing the risks and benefits of catheter ablation

The benefits may outweigh the risks if:

The risks may outweigh the benefits if:

  • You have symptoms that bother you a lot.
  • You don't want to take heart rhythm medicines.
  • Heart rhythm medicines aren't helping.
  • Medicines help, but their side effects bother you a lot.
  • You can't take the medicines because of other health problems.
  • You have only mild symptoms that don't really bother you.
  • You prefer to try heart rhythm medicines.
  • You aren't bothered by side effects of heart rhythm medicines.

2. Compare your options

 Have catheter ablation Don't have catheter ablation
What is usually involved?
  • The treatment is done in a hospital and takes 2 to 6 hours.
  • You probably won't be fully awake during the treatment. You may be lightly sedated or completely asleep.
  • You may have some discomfort, either from having to lie still or from the ablation itself. Talk to your doctor if you are worried about this.
  • Many people go home the same day.
  • When you have an episode, you try vagal maneuvers, such as bearing down, to slow your heart rate.
  • You try taking medicines to stop the abnormal heart rhythms.
What are the benefits?
  • Many people feel a lot better after this treatment.
  • If the treatment works, you won't need heart rhythm medicines anymore.
  • Vagal maneuvers and medicines relieve symptoms for some people.
  • You don't have to worry about the risks of ablation.
What are the risks and side effects?
  • Ablation has serious risks. They include stroke and heart attack.
  • About 1 out of 100 people might need a pacemaker after ablation.1
  • If ablation doesn't work the first time, you may have to have it done again.
  • You continue to have symptoms.
  • Heart rhythm medicines may increase your risk of getting a more serious heart rate problem. You will need frequent checkups so your doctor can watch you closely while you take these medicines.

Personal stories

Personal stories about considering catheter ablation

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I started having episodes of really fast heartbeats 2 years ago. It's this pounding in my chest-very scary. Medicines haven't really helped. I hate the idea of having a procedure like this. But I'm more afraid of the pounding in my chest. I'm going to try catheter ablation."

— Will, age 36

"I know that catheter ablation usually works really well for my type of heart problem. But no one can guarantee that it's completely safe. I'm not ready to take any more risks with my body. I'm going to keep using medicines to treat my fast heartbeat."

— Juan, age 72

"I don't like the idea of taking the rhythm medicines. I would rather have the procedure and fix this problem for good."

— Betty, age 57

"I'm not really bothered by my symptoms when I have an episode. I can usually stop it with vagal maneuvers like coughing. For now, I don't think I need to have this procedure."

— Paula, age 48

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have catheter ablation

Reasons not to have catheter ablation

I'm not worried about having a procedure that involves my heart.

I'm very worried about having a procedure that involves my heart.

       
More important
Equally important
More important

I'm bothered a lot by my symptoms.

My symptoms don't bother me.

       
More important
Equally important
More important

I don't want to have to take a heart rhythm medicine.

I want to try medicine to relieve my symptoms.

       
More important
Equally important
More important

The risks of ablation don't bother me as much as the risks of taking medicine.

I prefer the risks of taking medicine over the risks of having catheter ablation.

       
More important
Equally important
More important

My other important reasons:

My other important reasons:

  
       
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having catheter ablation

NOT having catheter ablation

       
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Does catheter ablation work well for supraventricular tachycardia (SVT)?

  • Yes
  • No
  • I'm not sure
That's right. Catheter ablation does work well to treat SVT.

2. Is catheter ablation the only treatment to relieve symptoms of SVT?

  • Yes
  • No
  • I'm not sure
That's correct. Some people can relieve their symptoms with vagal maneuvers or by taking heart rhythm medicine.

3. If ablation doesn't work the first time, can it be done again?

  • Yes
  • No
  • I'm not sure
That's right. You may need to have it done a second time. A second ablation usually works.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

     
Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.
 
Credits
ByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Primary Medical ReviewerMartin J. Gabica, MD - Family Medicine
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
References
Citations
  1. Calkins H, et al. (1999). Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. The Atakr Multicenter Investigators Group. Circulation, 99(2): 262-270. DOI:10.1161/01.CIR.99.2.262. Accessed January 19, 2016.
  2. Spector P, et al. (2009). Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. American Journal of Cardiology, 104(5): 671-677.
Other Works Consulted
  • Calkins H (2011). Supraventricular tachycardia: Atrioventricular nodal reentry and Wolf-Parkinson-White syndrome. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 1, pp. 987-1005. New York: McGraw-Hill.
  • Miller JM, Zipes DP (2015). Therapy for cardiac arrhythmias. In DL Mann et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th ed., vol. 1, pp. 685-720. Philadelphia: Saunders.
  • Olgin JE, Zipes DP (2015). Specific arrhythmias: Diagnosis and treatment. In DL Mann et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th ed., vol. 1, pp. 748-797. Philadelphia: Saunders.
  • Page RL, et al. (2015). 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. DOI: 10.1161/CIR.0000000000000311. Accessed September 23, 2015.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Current as of: October 5, 2017

Author: Healthwise Staff

Medical Review: Adam Husney, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology