Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android


The verb to ablate means to destroy or remove functionality of a structure. Catheter ablation involves delivering energy from a catheter to create a lesion eliminating a pathway or structure causative of, or involved in the manifestation of, an arrhythmia. Ablation was initially done to treat arrhythmias using surgical incisions. Seeking less invasive percutaneous treatment, direct current catheter ablation was developed, but it was difficult to titrate and direct. Radiofrequency ablation was first reported by Dr. Huang and colleagues1 and offered a much more precise and targeted energy source. Radiofrequency energy remains the most common energy source, but cryoablation has been used for several arrhythmias and accounts for over a third of atrial fibrillation ablations. Laser ablation, using a balloon, is also approved for atrial fibrillation. Additional sources under investigation include low-intensity ultrasound, electroporation (pulsed field ablation),2 and stereotactic, external X-beam ablation. Establishing the correct diagnosis (see Chapters 6, 7, 8, 9), and identifying the pathophysiologic and anatomic structure are critical to ablation success. Ablation targets vary in scope from focal sources such as atrial tachycardia, accessory pathways, or atrioventricular (AV) nodal pathways to linear (or otherwise extensive) ablation as in atrial flutter, other macroreentrant tachycardias, atrial fibrillation, or structural heart ventricular tachycardia (VT) (Table 17-1).

TABLE 17-1Overview of ablation of supraventricular arrhythmias.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.