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Cardiolucent

Treatment

Ablation Therapy (AFib, SVT, VT)

Catheter-based treatment to eliminate the electrical sources driving arrhythmia.

Catheter ablation is a minimally invasive procedure that targets the precise electrical pathways or focal sources driving an arrhythmia, using radiofrequency energy or cryotherapy to create small scars that block the abnormal signals. For atrial fibrillation (AFib), supraventricular tachycardia (SVT), and many ventricular tachycardias (VT), ablation can durably eliminate symptoms or significantly reduce the burden of episodes — often more effectively than long-term antiarrhythmic medications. The decision to proceed depends on the arrhythmia type, symptom burden, response to medications, and overall cardiac structure. Dr. Kedan evaluates whether ablation is the right next step and coordinates the procedure with electrophysiology colleagues at Cedars-Sinai.

What This Treatment Approach Includes

  • Detailed arrhythmia characterization with EKG, Holter or extended monitoring, and echocardiography
  • Discussion of ablation versus continued medication or other rhythm strategies
  • Pre-procedure evaluation: imaging, anticoagulation planning, anesthesia clearance
  • Coordination with Cedars-Sinai electrophysiology for the procedure itself
  • Post-ablation rhythm monitoring and medication adjustment
  • Long-term surveillance for recurrence and need for repeat procedure
  • Continued anticoagulation management when stroke risk warrants it

How It Works

During catheter ablation, thin flexible catheters are advanced through a vein in the groin to the heart, where high-resolution electrical mapping identifies the precise tissue driving the arrhythmia. The proceduralist then applies targeted energy — radiofrequency heat or cryothermal cold (and newer pulsed-field energy) — to create small lesions that interrupt the abnormal circuit or isolate the triggering area. For AFib, the most common approach is pulmonary vein isolation; for SVT and VT, the target depends on the specific circuit involved.

Who This Is For

  • Symptomatic paroxysmal or persistent atrial fibrillation, especially when medications have not worked or are not tolerated
  • Recurrent supraventricular tachycardia (AVNRT, AVRT, atrial tachycardia, atrial flutter)
  • Symptomatic premature ventricular contractions (PVCs) with high burden or LV dysfunction
  • Ventricular tachycardia in patients with or without structural heart disease
  • AFib patients seeking first-line ablation rather than years of rhythm-control medication
  • Recurrent arrhythmia after prior ablation, where a repeat procedure may complete isolation
  • Patients whose arrhythmia is contributing to heart failure or quality-of-life impairment

Monitoring and Follow-Up

The first three months after ablation are a "blanking period" during which transient arrhythmia recurrences are common and do not necessarily mean the procedure failed. Rhythm monitoring with a Holter or extended wearable monitor is typically repeated at intervals to assess true success. Anticoagulation is usually continued for at least two to three months regardless of rhythm, with longer-term decisions based on individual stroke risk. Dr. Kedan provides the longitudinal follow-up between and after the procedural milestones.

How Cardiolucent Manages This

Deciding whether to proceed with ablation involves trade-offs that benefit from extended, unhurried conversation. Dr. Kedan walks through the data on success rates, recurrence, and complications specific to your situation, coordinates the pre-procedure workup and timing with the electrophysiologist at Cedars-Sinai, and remains the continuity cardiologist before, during, and after the procedure. POCUS, same-day labs, and direct access keep the post-ablation period closely monitored.

Common Questions

Frequently Asked Questions

What is catheter ablation, and how is it different from open surgery?
Catheter ablation is performed through thin catheters introduced via a vein in the groin and advanced to the heart. There are no chest incisions, the procedure usually takes a few hours under sedation or general anesthesia, and most patients go home the same day or the next morning. Surgical ablation does exist for select cases, but the vast majority of ablations are catheter-based.
Who is a candidate for AFib ablation?
Patients with symptomatic paroxysmal or persistent atrial fibrillation, particularly when medications have not worked or are not tolerated, are typical candidates. Recent guidelines support ablation as a reasonable first-line therapy for many patients with paroxysmal AFib who prefer it over long-term rhythm-control medications. Atrial size, ejection fraction, and overall health all factor into the decision.
How successful is the procedure?
Success depends on the arrhythmia. Most SVTs (AVNRT, typical atrial flutter) have very high single-procedure success rates. AFib success is lower and depends on whether it is paroxysmal or persistent — single-procedure freedom from AFib is more common in paroxysmal disease, and a meaningful fraction of patients require a second procedure for complete isolation. VT ablation success varies widely based on the substrate. Dr. Kedan reviews realistic expectations specific to your case.
What are the main risks?
Catheter ablation is generally safe but does carry small risks of bleeding at the groin access site, blood clots and stroke, damage to nearby structures (esophagus, phrenic nerve, coronary arteries depending on target), heart perforation with pericardial fluid accumulation, and rarely the need for pacemaker. Risks are individualized and discussed in detail by the electrophysiologist before the procedure.
Will I still need medications after a successful ablation?
Anticoagulation is typically continued for at least two to three months regardless of rhythm. Longer-term continuation depends on your stroke risk profile, not just on rhythm — many patients with significant stroke risk remain on anticoagulation indefinitely even after a successful procedure. Antiarrhythmic medications can often be reduced or stopped after a successful ablation.
What is the recovery like?
Most patients return to light activity within a few days, with restrictions on heavy lifting and strenuous exertion for about a week. Some chest discomfort, transient palpitations, and fatigue are common in the first weeks. The three-month blanking period — when transient recurrences are common and do not signal failure — is when patience matters most.
What is the blanking period, and why does it matter?
The blanking period is the first three months after ablation when the heart tissue is healing and inflammation can trigger transient arrhythmia recurrences. Recurrences during this window are not used to judge procedural success — they often resolve as the scar matures. True success is assessed at three months and beyond with rhythm monitoring.
What happens if the arrhythmia comes back?
Recurrence is not unusual, especially with AFib, and is often addressed with a repeat ablation that achieves complete isolation. In some cases, medication is restarted, lifestyle factors (sleep apnea, alcohol, weight) are targeted, or a different rhythm strategy is considered. The path forward is individualized.
What lifestyle factors affect outcomes?
For AFib particularly, weight management, alcohol moderation or abstinence, treatment of sleep apnea, blood pressure control, and regular aerobic activity all meaningfully reduce recurrence rates. Lifestyle optimization is part of the ablation strategy, not a separate conversation.
How do I start an ablation evaluation with Dr. Kedan?
Schedule a consultation at the Beverly Hills office with prior EKGs, rhythm monitor reports, and echocardiogram results. Cardiolucent is a concierge practice and does not bill Medicare or insurance, though a detailed superbill is provided for out-of-network reimbursement. The procedure itself is performed at Cedars-Sinai. Call (310) 304-5555 or use the contact form.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.