Are there any long-term side effects of an ablation?

September 25, 2025 •

4 min read

While often effective, ablation procedures can carry long-term risks that vary significantly depending on the type of procedure performed. The potential long-term side effects of an ablation require careful consideration and discussion with your doctor before proceeding.

Quick Summary

Yes, certain ablation procedures have long-term side effects, which can differ widely based on the treated area. Potential issues range from recurrent symptoms and nerve damage to internal scarring and delayed diagnosis of other conditions.

Key Points

Risks are Type-Specific: Long-term side effects depend on the type of ablation (cardiac, endometrial, pain) and the specific tissue targeted.
Endometrial Scarring: Endometrial ablation can cause internal scarring that traps blood, leading to severe pain and complicating future cancer diagnosis.
Cardiac Recurrence: Cardiac ablation risks include the recurrence of arrhythmias, potentially requiring repeat procedures or a pacemaker.
Back Pain Worsening: Radiofrequency ablation for back pain may cause long-term nerve damage leading to muscle atrophy and potentially worse pain over time.
Ongoing Monitoring is Crucial: Follow-up care is essential, especially with endometrial ablations where scarring can hide future complications.
Thorough Discussion is Key: Always discuss the specific long-term risks associated with your procedure with an experienced specialist.

The Different Kinds of Ablation

An 'ablation' is a broad term for a medical procedure that uses heat, cold, or radiofrequency energy to destroy tissue. The long-term effects are entirely dependent on the type of ablation and the area being treated. For instance, the risks associated with a cardiac ablation, which targets heart tissue, are distinct from those of an endometrial ablation, which affects the uterine lining.

Cardiac Ablation (For Atrial Fibrillation or Arrhythmias)

Cardiac ablation aims to correct heart rhythm problems by creating small scars in heart tissue to block abnormal electrical signals. Long-term effects and success rates can vary. Some people find permanent relief, while others may see their arrhythmia return over time, sometimes requiring repeat procedures.

Recurrence of Arrhythmias: The irregular heartbeat may return months or years after the procedure.
Pulmonary Vein Stenosis: A potential risk is the narrowing of the pulmonary veins, which carry blood from the lungs to the heart.
Need for a Pacemaker: In some cases, ablation can damage the heart's electrical system, leading to a slow heart rate that requires a pacemaker.
Nerve Damage: Phrenic nerve damage, which can cause breathing problems, is a documented risk.
Fluid Accumulation: Chronic pericardial effusion (fluid around the heart) is a rare but serious long-term risk.

Endometrial Ablation (For Heavy Uterine Bleeding)

This procedure removes the uterine lining to reduce or eliminate heavy menstrual bleeding. While effective for many, it carries significant long-term risks, primarily related to scar tissue formation. It is not a sterilization procedure, and subsequent pregnancy is highly dangerous.

Intrauterine Scarring (Asherman's Syndrome): Formation of scar tissue inside the uterus is common and can partially or completely block the uterine cavity.
Hematometra and PATSS: Trapped blood from regenerating endometrium can cause painful conditions. Hematometra is blood trapped in the uterus, while Post-Ablation Tubal Sterilization Syndrome (PATSS) is blood trapped in the fallopian tubes, occurring only in women with a prior tubal ligation.
Pain and Recurrence: Many patients experience a recurrence of heavy bleeding or develop chronic pelvic pain months or years after the procedure, often requiring a hysterectomy.
Delayed Diagnosis of Cancer: Intrauterine scarring can mask postmenopausal bleeding, delaying the diagnosis of endometrial cancer.

Radiofrequency Ablation (RFA) for Chronic Pain

Used to treat chronic pain, particularly in the lower back, RFA uses heat to lesion the nerves transmitting pain signals. A major long-term side effect involves the muscles supporting the spine.

Multifidus Muscle Atrophy: RFA can damage nerves innervating the multifidus muscle, a key spinal stabilizer. This atrophy can potentially worsen chronic back pain and lead to further degenerative conditions.
Neuropathic Pain: In some cases, the nerve may be further irritated, leading to worsened nerve pain or the formation of a neuroma.
Potential for Worsening Pain: Denervating crucial stabilizing muscles may lead to long-term issues that are more complex than the initial pain.

Ablation Type and Long-Term Outcomes: A Comparison


Feature	Cardiac Ablation	Endometrial Ablation	RFA for Pain
Primary Goal	Correct irregular heart rhythms	Reduce heavy menstrual bleeding	Block pain signals from nerves
Key Long-Term Side Effects	Arrhythmia recurrence, pulmonary vein stenosis, need for pacemaker	Intrauterine scarring, hematometra, PATSS, obscured cancer diagnosis	Nerve damage, multifidus muscle atrophy, worsened back pain
Long-Term Success Rate	Varies; often requires repeat procedures or medication	Hysterectomy rate can be high, especially in younger women	Pain relief is not permanent; nerve regrowth possible
Pregnancy	Not directly affected	Not a sterilization procedure, but future pregnancy is highly risky	Not directly affected
Monitoring	Regular cardiology follow-up	Special consideration for postmenopausal bleeding; hard to evaluate uterus	Ongoing monitoring for pain and muscle function

Managing and Mitigating Long-Term Risks

While no procedure is without risk, there are steps that can help mitigate potential long-term complications:

Select the Right Candidate: Ensuring that a patient is an ideal candidate for a specific ablation procedure is crucial. For example, some ablations are not suitable for patients with adenomyosis or fibroids.
Discuss All Alternatives: Explore alternative treatment options, such as medication, before opting for an irreversible procedure.
Use of Experienced Practitioners: Operator and hospital volume have been linked to lower complication rates, so seeking care from an experienced provider is recommended.
Long-Term Follow-up: Ongoing medical surveillance is necessary to monitor for potential issues, especially those that may not appear for years. For endometrial ablations, particular attention is needed for bleeding after menopause.
Maintain Communication: Be proactive in communicating any new or returning symptoms to your healthcare provider, even if you are amenorrheic after an endometrial ablation.

For more detailed information on cardiovascular health, consult resources like the American Heart Association. This organization provides valuable information on heart conditions and treatments.

Conclusion: Weighing Risks and Benefits

Ablation can be a highly effective treatment for various conditions, but the decision to proceed requires a thorough understanding of the specific long-term side effects. Patients must weigh the potential benefits of the procedure against the risks, considering both short-term recovery and possible long-term outcomes. The effects are not uniform across all ablation types, so an in-depth, personalized discussion with a healthcare provider is essential. Awareness of delayed complications, such as internal scarring or damage to surrounding structures, empowers patients to make informed decisions and seek appropriate monitoring and follow-up care for years to come.

Frequently Asked Questions

Yes, long-term cyclic pelvic pain is a documented complication of endometrial ablation. This can occur due to intrauterine scarring that traps blood from persistent endometrial tissue, causing pressure and pain in the uterus or fallopian tubes.

Yes, long-term effects of cardiac ablation can include the recurrence of an irregular heartbeat, the need for a pacemaker if the electrical system is damaged, and rare but serious complications like pulmonary vein stenosis.

Pregnancy is highly unlikely after endometrial ablation but is considered very risky. Any pregnancy that does occur is associated with increased risks of miscarriage, ectopic pregnancy, and other severe complications.

Radiofrequency ablation aims to lesion nerves to stop pain signals, but nerves can regenerate, causing pain to return. In some cases, nerve inflammation or neuroma formation can occur, potentially leading to long-term or worsened neuropathic pain.

Monitoring can be difficult because scarring complicates future evaluations. If a patient reports pain or postmenopausal bleeding, imaging like MRI is often required. Periodic ultrasounds are sometimes recommended for high-risk patients, but obtaining a reliable biopsy is challenging.

Yes, a significant concern with radiofrequency ablation for back pain is that it can damage nerves that control the multifidus muscle, a key spine stabilizer. This can cause muscle atrophy, potentially worsening chronic back pain over the long term.

Ablation failure means the original symptoms, such as heavy bleeding or irregular heartbeat, may return. For endometrial ablation, this often leads to a hysterectomy. For cardiac ablation, a repeat procedure or lifelong medication may be necessary.