A catheter ablation is a minimally invasive procedure used to treat heart rhythm disorders (arrhythmias). Thin, flexible wires called catheters are guided through a vein — usually in the groin — to the heart, where the abnormal electrical pathways causing the arrhythmia are identified and permanently inactivated using either radiofrequency energy (heat) or extreme cold (cryoablation).

The procedure is performed under sedation or general anaesthetic. You will not feel any pain during the ablation itself. Most patients go home the same day or the following morning and recover quickly.

The duration depends on the type of arrhythmia being treated. A straightforward ablation for SVT or atrial flutter typically takes 1–2 hours. Atrial fibrillation (AF) ablation usually takes 1-2 hours. More complex procedures such as ventricular tachycardia (VT) ablation may take 4 hours or longer.

Your electrophysiologist will give you a more specific estimate at your pre-procedure consultation.

Most patients recover quickly. You can usually return home the same day or the morning after the procedure. Most people resume light activity within a few days and return to normal work within one week.

Heavy lifting and strenuous exercise should be avoided for a week or so. You may experience some temporary chest discomfort in the first 2-3 days or palpitations in the first few weeks — this is normal and usually settles as the heart heals. Full guidance will be given before you are discharged.

An electrophysiology (EP) study is a diagnostic procedure used to investigate abnormal heart rhythms. Catheters are placed inside the heart to record its electrical activity in detail and to identify exactly where arrhythmias are originating from.

EP studies are often combined with an ablation in the same sitting — once the abnormal pathway is found, it can be treated immediately. The procedure is performed under local anaesthetic with sedation, and is generally well tolerated.

A pacemaker is a small battery-powered device implanted under the skin — usually just below the collarbone. It continuously monitors your heart rate and delivers small electrical impulses to keep the heart beating at a safe, steady pace when it beats too slowly or pauses.

Pacemakers are typically recommended for conditions causing a dangerously slow heart rate, such as heart block or sick sinus syndrome. Modern pacemakers are very small and reliable, and most patients adapt to them quickly with minimal impact on daily life.

An ICD is similar to a pacemaker but also has the ability to detect and treat life-threatening fast heart rhythms such as ventricular tachycardia (VT) or ventricular fibrillation (VF). If the ICD detects a dangerous rhythm, it delivers a shock or anti-tachycardia pacing to restore a normal heartbeat.

ICDs are recommended for people who have survived a cardiac arrest or who are at high risk of one — usually due to structural heart disease or certain inherited cardiac conditions. The vast majority of patients with an ICD tolerate it very well and report significant reassurance from the device.

Cardiac resynchronisation therapy (CRT) is a specialised type of pacemaker used in patients with heart failure and a particular electrical delay called left bundle branch block. By pacing both sides of the heart simultaneously, CRT improves the coordination and efficiency of the heart's contractions.

CRT often leads to a significant improvement in breathlessness and exercise tolerance, and reduces the risk of hospitalisation and death in carefully selected patients. CRT devices can also incorporate an ICD function (called CRT-D), providing both resynchronisation and protection against dangerous arrhythmias.

SVT (supraventricular tachycardia) is a common heart rhythm condition where the heart suddenly beats very fast — typically 140–220 beats per minute. Episodes can start and stop abruptly and may last anything from a few seconds to several hours.

SVT is caused by a short circuit or an extra electrical pathway in the upper chambers of the heart. While episodes can feel frightening, SVT is not usually dangerous in people with an otherwise healthy heart, and it is very treatable.

For the vast majority of people, SVT is not dangerous. It is uncomfortable and can cause significant symptoms — such as palpitations, breathlessness, dizziness, or chest tightness — but it rarely causes serious harm in an otherwise healthy heart.

Very fast or prolonged episodes can occasionally cause a near-blackout (pre-syncope). If SVT is severely symptomatic or affecting your quality of life, highly effective treatments including catheter ablation are available and are considered curative in most cases.

Yes. Catheter ablation is highly effective for SVT and is considered curative in most cases. Success rates are typically 95% or higher, depending on the type of SVT. The two most common types — AVNRT and AVRT — respond particularly well to ablation.

The procedure is minimally invasive, carries a low risk of complications, and most patients are discharged the same day. Many people describe the ablation as life-changing, as it can permanently eliminate the need for long-term medication.

Common triggers include caffeine, alcohol, stress, fatigue, dehydration, and sometimes exercise. Some people find that bending over or sudden changes in posture can provoke an episode. However, SVT can also occur without any obvious trigger.

Keeping a symptom diary — noting what you were doing, eating, or drinking when an episode started — can help identify personal triggers and is useful information to bring to your electrophysiologist appointment.

Atrial fibrillation (AF) is the most common sustained heart rhythm disorder. In AF, the upper chambers of the heart (the atria) beat in a rapid, chaotic, and disorganised way rather than contracting in a coordinated manner. This produces an irregular pulse and can cause symptoms including palpitations, breathlessness, fatigue, and dizziness — though some people have no symptoms at all.

AF may be intermittent and self-terminating (paroxysmal AF), may persist without stopping on its own (persistent AF), or may be permanent. It becomes increasingly common with age and is associated with high blood pressure, heart valve disease, and other cardiac conditions.

AF itself is rarely immediately life-threatening, but it carries two important risks. First, it significantly increases the risk of stroke — because blood can pool and form clots in the fibrillating atrium, which can then travel to the brain. Second, if the heart rate is poorly controlled over a long period, AF can contribute to heart failure.

The stroke risk is managed with blood-thinning medication (anticoagulation), and the rate and rhythm can be controlled with medication or ablation. With appropriate treatment, the great majority of people with AF live full and active lives.

AF can often be substantially improved or put into long-term remission, though the concept of 'cure' is more complex than for conditions such as SVT or atrial flutter. Catheter ablation offers the best chance of restoring and maintaining normal heart rhythm, particularly in patients with paroxysmal AF and in younger patients treated earlier in the course of the disease.

Lifestyle changes — including weight loss, good blood pressure control, reducing alcohol intake, increasing exercise, and treating sleep apnoea — are also powerful tools that can significantly reduce AF burden. In some patients, a combination of ablation and lifestyle optimisation achieves lasting freedom from AF.

Success rates depend on the type of AF and individual patient factors including age, duration of AF, heart size, and associated conditions. For paroxysmal AF (intermittent episodes), approximately 70–80% of patients are free of AF after a single ablation procedure; some require a second procedure to achieve this.

For persistent AF, success rates following a single procedure are somewhat lower. It is important to have realistic expectations — AF ablation is the most effective rhythm control strategy available, but it is not guaranteed to be curative for every patient. Dr Kyriacou will discuss your individual situation and likelihood of success at your consultation.

Whether you need anticoagulation (blood thinners) depends on your personal stroke risk, which is calculated using a scoring system called CHA₂DS₂-VASc. This takes into account factors such as your age, blood pressure, diabetes, whether you have had a previous stroke, and any heart failure. Most patients with AF and one or more risk factors are recommended anticoagulation.

Modern anticoagulants — called DOACs (direct oral anticoagulants) — are very effective, easy to take (once or twice daily), and do not require regular blood tests. Importantly, anticoagulation is usually continued even after a successful ablation procedure, because AF can recur silently and the stroke risk often persists.

Atrial flutter is a regular, fast heart rhythm where the upper chambers beat in a rapid, organised electrical circuit — typically around 300 beats per minute. The lower chambers usually beat at half this rate (around 150 bpm), producing a fast but regular pulse.

Atrial fibrillation (AF), by contrast, is irregular and chaotic — there is no organised pattern at all. Both conditions carry similar stroke risks and are often treated with anticoagulation. Unlike AF, typical atrial flutter responds very reliably to catheter ablation, with cure rates exceeding 95%.

Atrial tachycardia is a fast heart rhythm originating from a focal point in one of the upper chambers of the heart. Unlike SVT, the AV node is not part of the arrhythmia circuit, though it can be affected by it.

It can cause persistent or paroxysmal palpitations and, if left untreated over a long period, may occasionally contribute to a reduction in heart function. Catheter ablation is an effective treatment option, targeting the specific point in the atrium where the abnormal impulses arise.

Yes — typical atrial flutter has one of the highest cure rates of any arrhythmia treated with catheter ablation. A procedure called cavotricuspid isthmus (CTI) ablation targets a critical narrow channel in the right atrium through which the flutter circuit must pass, permanently breaking the circuit.

CTI ablation has a success rate of over 95% and most patients are free of flutter after a single procedure. It is a well-established, low-risk procedure and is generally performed as a day case.

Ventricular ectopics — also called premature ventricular contractions (PVCs) — are extra heartbeats that originate from the lower chambers of the heart. They produce a distinctive 'thud', 'flip', or 'skipped beat' sensation and are extremely common, experienced by the majority of adults at some point in their lives.

They often show up on an ECG or Holter monitor and are one of the most frequent reasons for cardiology referral. In people with a structurally normal heart, they are almost always benign.

In people with a structurally normal heart, ventricular ectopics are almost always benign and are not dangerous. They can feel very unsettling and are sometimes described as the most troublesome palpitation sensation, but in themselves they do not pose a health risk.

A standard assessment — including an ECG, echocardiogram (heart ultrasound), and often a Holter monitor — is performed to confirm the heart is otherwise healthy, after which reassurance is the most important treatment. Knowing that the extra beats are harmless is often enough to reduce how much they bother you.

Treatment may be considered when ectopics are very frequent — typically more than 10,000 per day — when they are causing significant symptoms that affect daily life, or when the high burden of ectopics appears to be affecting heart function in a small proportion of cases.

A 24–72 hour Holter monitor is used to count the ectopic burden and assess their pattern. Treatment options include lifestyle modifications (reducing caffeine and alcohol), medication, and catheter ablation.

Yes. Catheter ablation is an effective option for frequent, symptomatic ventricular ectopics, particularly when they arise from well-defined sites such as the right ventricular outflow tract (RVOT) — the most common location. Success rates are high for ectopics from common locations.

Ablation is typically considered when symptoms are troublesome and medication has not helped, or when a high ectopic burden is thought to be contributing to a reduction in heart function (ectopic-induced cardiomyopathy). The procedure can significantly reduce or eliminate the ectopics.

Ventricular tachycardia (VT) is a fast heart rhythm originating from the lower chambers (ventricles) of the heart. The heart beats very rapidly — typically above 100 beats per minute and often 150–200 bpm or more. VT can be brief and self-terminating (non-sustained), or sustained and require urgent treatment.

The significance of VT ranges from entirely asymptomatic to life-threatening, depending on how fast the heart is beating, how long the episode lasts, and whether there is underlying structural heart disease. All patients with VT should be assessed by a specialist electrophysiologist.

VT can be dangerous, particularly in people with underlying structural heart disease such as a previous heart attack, cardiomyopathy, or heart failure. In these cases, VT can degenerate into ventricular fibrillation (VF), which is a cardiac arrest requiring immediate treatment.

In people with a completely normal heart, some forms of VT (known as idiopathic VT) are less dangerous but still warrant careful specialist evaluation and treatment. It is important not to dismiss VT symptoms — early assessment allows the risk to be properly characterised and the right treatment to be offered.

Treatment depends on the type of VT and the underlying heart condition. The main options are antiarrhythmic medications (to reduce the frequency of episodes), an ICD (to automatically detect and treat dangerous rhythms), and catheter ablation (VT ablation).

In many patients, a combination approach is used. For idiopathic VT in a structurally normal heart, ablation alone is often curative. For VT in the context of structural heart disease, ablation may significantly reduce the frequency of episodes and ICD shocks, usually in combination with an ICD for ongoing protection.

VT ablation is a catheter-based procedure in which the abnormal circuits or scar tissue responsible for causing VT are identified and ablated. It is a more complex procedure than ablation for SVT or AF and is typically performed in specialist centres with experienced electrophysiologists.

In people with idiopathic VT in a structurally normal heart, success rates are generally excellent — over 85–90%. In VT associated with structural heart disease, the aim is to reduce the frequency and burden of VT episodes rather than complete elimination; outcomes vary depending on the extent of the underlying disease. Dr Kyriacou has extensive experience in complex VT ablation.

Palpitations — the awareness of your own heartbeat, often described as a fluttering, pounding, racing, or 'skipped beat' sensation — have many possible causes. The most common include extra heartbeats (ectopics), anxiety, stress, caffeine, alcohol, dehydration, thyroid problems, anaemia, and heart rhythm disorders such as SVT or atrial fibrillation.

Many palpitations are entirely benign and do not require treatment beyond reassurance. However, palpitations that are persistent or very frequent, or that are associated with blackout, breathlessness, or chest pain, should always be investigated by a cardiologist to rule out a more significant underlying cause.

You should seek a cardiology assessment if you experience any of the following: a sustained rapid or irregular heartbeat; palpitations associated with dizziness, breathlessness, or loss of consciousness; unexplained blackouts or near-blackouts (syncope or pre-syncope); chest pain or pressure; breathlessness that seems out of proportion to your activity level; or if an ECG, Holter monitor, or other investigation has shown an abnormality.

Early assessment is always preferable — many heart rhythm conditions are very effectively treated when caught early. Do not ignore symptoms that are affecting your quality of life or that feel out of the ordinary for you. For urgent symptoms — such as sustained chest pain or a blackout — please attend your nearest Emergency Department.

A cardiologist is a doctor who has specialised in the heart and cardiovascular system, diagnosing and treating a wide range of heart conditions. An electrophysiologist (EP) is a cardiologist who has undergone further specialist training — typically an additional 2–3 years — specifically focused on the electrical system of the heart.

Electrophysiologists diagnose and treat abnormal heart rhythms (arrhythmias), perform catheter ablation procedures, implant pacemakers and defibrillators, and manage complex cases involving heart rhythm disorders. Not all cardiologists are trained to perform ablation or implant devices — this requires the additional EP subspecialty training. Dr Kyriacou is both a Consultant Cardiologist and a Cardiac Electrophysiologist.