Specialist electrophysiology care
Dr Rohan WijesurendraConsultant Cardiologist & Electrophysiologist
1,500+ ablationsPersonally performed catheter ablation procedures
Oxford-based carePrivate care at Nuffield Health The Manor Hospital
NHS practiceAcademic & researchGMC registrationHospital profile
Introduction
Catheter ablation is a minimally invasive procedure used to treat selected heart rhythm disorders. Thin tubes, called catheters, are passed through a vein—usually at the top of the leg—and guided to the heart. We use them to understand the rhythm precisely and, where appropriate, to treat the electrical pathway or small area of tissue responsible for it.
The aim depends on the rhythm being treated. For some forms of supraventricular tachycardia (SVT) or atrial flutter, ablation can be curative. For atrial fibrillation (AF), it is usually intended to reduce the burden of AF and improve symptoms, rather than to guarantee that AF will never recur. For ventricular ectopic beats or ventricular tachycardia, the plan is tailored carefully to the rhythm, the structure and function of the heart, and the impact on day-to-day life.
Whether ablation is right for you depends on the diagnosis, your symptoms, previous treatment, relevant tests and the alternatives. I explain the likely benefits, the limits of the procedure and the risks in the context of your own situation before you decide. If the decision concerns AF, Should I have an AF ablation? may be a useful starting point.
I have experience of more than 1,500 catheter ablation procedures, including thermal energy and pulsed field ablation, as of August 2026.
What happens during ablation
An electrophysiology study is often the first part of the procedure. This uses the catheters to record the heart’s electrical signals and, when appropriate, to reproduce the rhythm in a controlled way. It allows the treatment to be directed at the correct target.
Once the target has been confirmed, energy is delivered through a catheter to modify or isolate the tissue causing the rhythm problem. The procedure may be performed with local anaesthetic and sedation or, for some procedures, under general anaesthetic. The planned approach, expected duration and recovery arrangements are discussed in advance.
After the procedure, the catheters are removed and pressure is applied to the access site. Most people spend a period of observation in the day unit before going home; some procedures require an overnight stay. You will receive clear advice about medication, driving, activity, wound care and follow-up.
Pulsed field ablation for atrial fibrillation
I have access to pulsed field ablation (PFA) and routinely use it when it is the appropriate approach, including for many suitable first-time AF ablation procedures. PFA uses very brief electrical pulses rather than heat or freezing energy to treat the areas of heart tissue involved in AF, most commonly around the pulmonary veins.
PFA is designed to target heart muscle more selectively than conventional thermal techniques. It is an important addition to radiofrequency and cryoablation, but it is not automatically the right choice for every patient or every ablation. The best energy source and catheter approach depend on the type and duration of AF, your heart anatomy, any previous procedures and the specific treatment goals.
During your consultation, I will explain whether PFA is suitable in your case, how it compares with the alternatives and what the practical implications are for your procedure. The same careful discussion of benefits, uncertainties and recognised procedural risks applies whichever ablation technology is used.
Preparing for a procedure
Before ablation, the diagnosis and planned target are reviewed carefully. You may need an ECG, rhythm monitoring, an echocardiogram, blood tests or other imaging, depending on the rhythm and the planned procedure. For AF ablation, it is especially important to make a clear plan for anticoagulation and any rhythm medication.
You will receive instructions about medication, fasting, arrival time, recovery and whether you need someone to take you home. Please tell the team about all medicines, allergies, previous reactions to sedation or anaesthetic, and any possibility of pregnancy. Do not stop anticoagulation or anti-arrhythmic medication unless you have been given specific advice to do so.
Afterwards there is usually a period of observation while the access site settles. Bruising or tenderness at the top of the leg is common and usually settles. Recovery, restrictions and the follow-up plan depend on the procedure and rhythm being treated. Some patients experience temporary palpitations or extra beats during recovery; this does not necessarily mean the procedure has not worked, but it should be discussed with the team if symptoms are concerning or persistent.
Benefits, risks and alternatives
For some rhythm disorders, ablation offers the prospect of a durable cure. In others, particularly AF, it may reduce symptoms, episodes, hospital attendances or dependence on rhythm medication. It is important to balance this potential benefit against the option of medication, observation, cardioversion or another treatment plan.
The risks vary with the planned procedure and are discussed in detail before consent. They can include bleeding, bruising or damage to a blood vessel at the access site, and less commonly bleeding around the heart, stroke, damage to the heart’s normal electrical system or a need for further treatment. AF ablation has additional risks that are discussed separately. Your personalised discussion will cover the risks that are relevant to you, rather than relying on a generic list.
Key points
- The procedure is used for several rhythm disorders, including many types of SVT and some cases of AF.
- Pulsed field ablation is available and is routinely used when appropriate, including for many suitable first-time AF ablation cases.
- Benefits, limitations and procedural risks should be discussed in detail before a decision.
- For some rhythms, ablation may reduce the need for long-term medication.
Patient note
“Ablation is a decision to make with a clear diagnosis and a realistic understanding of what it can—and cannot—achieve.”
Questions before catheter ablation
What rhythm is being treated? What is the expected chance of improvement? What are the alternatives and risks?
FAQ
Will ablation cure my rhythm problem?
For some rhythms, such as many SVTs and typical atrial flutter, ablation can be highly effective and may be curative. AF and more complex rhythms can also improve significantly, but results vary according to the rhythm, the heart and individual circumstances.
Is pulsed field ablation available?
Yes. Pulsed field ablation is available for appropriate AF cases, including many suitable first-time AF ablation procedures. It is one of several technologies that may be considered; your treatment plan will be based on what is most appropriate for your rhythm and circumstances.
Will I still need medication after ablation?
That depends on the rhythm, the reason for the medication and the result of the procedure. Some medication may be continued for a period after ablation, particularly anticoagulation for AF. Any changes are made as part of your follow-up plan rather than stopped independently.