Radiofrequency (RF) ablation: a Cath Lab 101 guide
Reviewed by Rodnie Oro, cath lab charge nurse · Last reviewed: October 2026 · Education only, not medical advice
Radiofrequency ablation in one minute
What it is: using heat from radiofrequency energy at a catheter tip to create tiny scars in the heart tissue causing an abnormal rhythm.
Who it is for: people with rhythms such as SVT, atrial flutter, atrial fibrillation and some ventricular rhythms.
Main risks: bruising in the groin, fluid around the heart, damage to the normal electrical system needing a pacemaker, and rarely stroke.
Usually: under sedation or general anaesthetic, 1–4 hours, home the same or next day.
On this page: What is radiofrequency ablation? · Who is it for? · When is it done? · Step by step · Recovery · Risks · Kit list · First time in the lab? · FAQ
What is radiofrequency ablation?
Abnormal rhythms often come from a small area, or an extra electrical pathway, in the heart.
- an EP study finds the source
- a 3D mapping system may build a map of the heart
- the ablation catheter tip is placed on the target and RF energy heats a small area, creating a scar that blocks the abnormal signals
For AF, the aim is usually to isolate the pulmonary veins.
New to the acronyms? See the Cath Lab Abbreviations A–Z.
Who is it for?
It may be considered for people with:
- SVT (including AVNRT and accessory pathways)
- atrial flutter
- atrial fibrillation
- some ventricular rhythms
The decision is made by your heart team, who will talk through the reasons, the alternatives and the risks with you.
When is it done?
It can be planned in advance or done urgently. Before it, you usually have:
- blood tests, including kidney function and blood count
- an ECG, and often an echo or other scan
- a review of your medicines, especially blood thinners and diabetes medicines, as per centre protocol
- a chance to ask questions and give consent
Step by step
1. Getting ready
You lie on the table. Sticky pads go on your chest and back, and ECG, blood pressure and oxygen are monitored. You usually have sedation or a general anaesthetic, as per centre protocol. The groin is cleaned and numbed.
2. Access
Using ultrasound, sheaths are placed in the femoral vein in the groin, sizes per device and operator. Catheters are passed up to the heart under X-ray and a 3D mapping system.
3. Ablation
- A. Map. The source of the rhythm is found.
- B. Target. The ablation tip is placed on the target.
- C. Burn. RF energy is applied in short bursts.
- D. Test. The team checks the rhythm can no longer be triggered.
You may feel some discomfort or warmth in the chest during energy delivery; pain relief is given.
4. Finishing
The catheters and sheaths are removed. The groin is closed with pressure or a stitch, per device and operator.
Recovery and aftercare
- First hours: bed rest while the groin settles; checks of the groin, rhythm and blood pressure, as per centre protocol.
- Going home: often the same day or the next morning.
- Groin: avoid heavy lifting and strenuous exercise for about a week.
- Medicines: take blood thinners and rhythm medicines exactly as advised.
- Driving: DVLA rules depend on the rhythm problem; ask your team.
- Follow-up: clinic review, sometimes with an ECG or heart monitor.
Call 999 if you have chest pain, breathlessness, fainting, signs of a stroke, or heavy bleeding or swelling at the access site.
Risks and complications
Your team will explain the risks that apply to you. Possible problems include:
- bruising or bleeding in the groin
- damage to a vein or artery in the groin
- new rhythm problems, sometimes needing a pacemaker (uncommon)
- fluid or bleeding around the heart (tamponade) (uncommon)
- stroke or blood clots (rare)
- the original rhythm problem coming back
Cath lab kit list (printable)
Barts example kit list
An example from one UK centre, written generically. Every lab has its own protocol, and sizes and doses vary.
- venous sheaths in the groin, sizes per device and operator
- diagnostic EP catheters, per operator
- recording system and stimulator
- ultrasound for vein access
- heparin, as per centre protocol
- sedation or anaesthetic, as per centre protocol
- RF ablation catheter and generator, per device and operator
- 3D mapping system, per operator
- irrigation pump and saline, if irrigated
- transseptal kit for left-sided targets, per operator
Procedural steps (Barts example)
- EP study and mapping
- Transseptal puncture if needed
- Ablation lesions applied
- Waiting period and re-testing
- Catheters out; groin closure
First time in the cath lab?
đź’ˇ First-time tip
- Return pad. Check the RF return (grounding) pad.
- Irrigation. Watch the saline volume.
- Pain relief. Have it ready.
- Watch the PR. Report any heart block during ablation near the AV node.
FAQ
Is it a cure?
For many rhythms it can be; your team will discuss.
Will I need a pacemaker?
Rarely.
Does it hurt?
Some discomfort; sedation and pain relief are given.
Related Cath Lab 101 guides
Sources
All checked on 10 October 2026. Each page's own date is shown where it gives one.
- Van Gelder IC, et al. 2024 ESC Guidelines for the management of atrial fibrillation. Eur Heart J 2024;45(36):3314–3414. PubMed 39210723
- Zeppenfeld K, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022;43(40):3997–4126. PubMed 36017572
- StatPearls (NCBI Bookshelf), search: catheter ablation radiofrequency. ncbi.nlm.nih.gov/books
Disclaimer
Education only. This page is for general education for healthcare students, cath lab staff and curious readers. It isn't medical advice and doesn't replace advice from your own doctor, heart team or local unit protocols. Equipment and medicines are described generically. No product or manufacturer is recommended. If you think someone is having a heart emergency, call 999.
Disclosure: I work for a company that makes a device used in this procedure. This page is independent education, isn't sponsored or reviewed by any company, and doesn't recommend any product.
All diagrams on this page are original illustrations created for rodnieoro.com.
