I so waited for others to post once they'd gone through this ordeal so here I go for all who are curious. I will try to answer all the questions I had prior to my pulmonary vein isolation/ablation procedure.
No GA, general anesthetic, light sedatives for; the TEE/TOE, US or UK spelling, (transesophageal echocardiogram ) , and some for the ablation, and I was cardioconverted once when I didn't return to SR. I was put to sleep for ten minutes for the cardioversion, no feeling of it and no memory. Start to finish about 4.5 hours.
First off, if this works, I would do it again. That should set all the folks to rest who are terrified! I can still feel a small occasional arrhythmia, palpitations but nothing like AFib and no tachycardia which always accompanied Afib for me. This is normal, and with time when the ablation points have properly scarred over, hopefully all will disappear. "Cardiac memory" is still in play. My accountant wrote me a note the morning of the surgery telling me her husband had the procedure a few years ago and is totally free of Afib still today.
The whole notion clearly is frightening even though I have had prior operations and am fascinated by surgery. The more I approached the subject - the heart - as a muscle, the less I was frightened of them routing around in there! I had an exceptional team from start to finish. The micro-incision to the groin , was no more painful than a typical injection anywhere. I notice the incision only if I push on it, and no pain walking. I did not move the leg for the time designated. I do have a huge bruise on the back of my leg. Maybe the tape which held down the compression bandage? In any case NO discomfort). I have slight chest discomfort - very slight - as when you have a nasty cough and breathing very deeply causes you to feel a mild tightness. I truly have to breathe very deeply to notice, a bit more yesterday but by no means "painful".
I did not require a Foley catheter (bladder) despite my concerns that I would be desperate if in Afib so long!
Medications: Xarelto 20mg 1x day for 3 months, Flecainide 50mg 2x day and metoprolol 12.5mg 2x day for 3 weeks.
These choices were made personal to my situation - they are not a recommendation! Just info.
Hmmm, what else? I didn't sleep at all the night after in the hospital as they made too much noise in the halls and I was too proud to take something to sleep. Take it if you have trouble and get a good night's sleep!
The rest, time will tell and I will continue to post the results. Everyone here has been so kind - it made a difference to me going in and coming out! I thought of all my kind friends and family who were "there" for me in spirit, and as they began the procedure you folks were all included in my thoughts as well!
Take care, let's hear it for NO Afib - in whatever manner you each choose to treat it.
Odd moment to say so, but... FOLLOW YOUR HEART!
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iris1205
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That all sounds pretty good, Iris. Did you have a long wait on the day or did they get going quite quickly? Sounds like you were less away in happyland than I was. I found sleeping at night a bit difficult too - dozed rather than slept. Yes, I'd do it all again too - felt I was in good and very skilful hands with a lot of technical backup.
Thank you Bob, I am off from Wednesday until this Sunday and then I will play it by ear. Apart from being a bit tired and a bit sore I feel fine. Tired primarily due to lack of sleep during the night at the hospital! Dr says GA takes more time to eliminate from your system which could be why it takes longer to recover.
Hah, thanks, not so brave, nothing else was proposed AND in the past I watched in operating rooms so I wanted to see the procedure. They did give a light sedative so I only knew what was happening, actually was frustrated that I didn't follow better! They were quite attentive to me not having any discomfort and called the anesthetist immediately for the DC cardioversion. The two EPs literally swept me off my feet, it was quite amazing.
I have to say my procedure did have 3 complications, not that I was aware of them until I read my EP's letter to my GP. Evidently a catheter wire broke, the mapping system didn't work properly and he touched my AV node which stopped my heart briefly, woke up to nurse pumping my chest. Happy to say it hasn't put me off as still delighted at feeling so much better.
Oh good Cdreamer, not on my own. Have never noticed this peculiarity!
I handed in an Advance Directive saying I don't want to be resuscitated if the outcome is not optimistic and my EP came to discuss it because they do need to recuscitate sometimes. Glad you are still enthusiastic. I've the feeling ablation has a very high success rate and while there are risks and potential complications, the life changing benefits far outweigh the small chance of failure.
Scary to wake and find a nurse pumping your chest! I take it the catheter wire didn't break in two?
Don't know the details, not sure I really want to, I know there has been a big recall on one type of catheter so which is one of the reasons there may be delays in some clinics. Oddly enough it wasn't scary at all which I put down to the sedatives. It really only stopped very briefly, about 15 seconds andI am feeling so much better I am just really grateful.
He said the reason he touched the AV node, he was in the right atria trying to do the Flutter line, was because my right Atria also has unusual physiology, is twisted and unusually small. So my heart has a hole, lacking a pulmonary vein and a twisted atria.... Mmmm..... Seems to have served me very well for the last 63 years though so I am not complaining.
Yes, if it works, it doesn 't matter much if it is constructed in a manner that is not the norm. Tricky for surgery. I don't have a 'pair' of feet, either. have a left foot and a right foot and the toes are similar, but not the same.
Can you tell me where in the groin the incision is made. I am having an ablation in 3 weeks and need to have two incisions, one on each side apparently. For some reason this is what scares me the most. I had a procedure done last year to have a interstim device inserted near my sacral nerve for OAB and they used lidocane injection for numbing the implatation site and it hurt like hell.....so I guess that's what I am concerned about
Same here.... 1/2 centimeter down from the crease and towards the inside of the center of your thigh. Truly, I hate injections, and it was swift and quick, would never have known it was an incision. NOT TO WORRY and I wouldn't hide the truth - no trust afterwards!
Keep in mind - anything dealing with what was probably already an inflamed site would be sensitive to an injection until it was fully administered. The groin won't feel any different than your arm or the buttocks - actually easier as no strong muscle.
Actually I had a stitch in each of my groins after my last ablation & had no bruising or evidence of incision at all afterwards. ( unlike previous 2 where I had much bruising & a haemotoma )
Looking at my punctures (ablation 12 days ago) they are almost in the crease at the top of the leg, top one just less than half a centimetre away and looking down about 33 minutes past the hour - not very far from the centre of the leg. They are I think in the femoral vein if you want to look at a circulatory diagram. Did not experience any pain whatsoever with numbing - in fact no pain at all anywhere at any stage. I could tell just before I drifted off they were busy there as there was a sensation of pressure. No pain, huge gain.
Thank you so much for posting this, it will be really helpful for anyone who is awaiting the procedure... It sounds as if everything went really well, take care and have a good recovery!
Don't you just love those little lead skirts and waistcoats! Just like Roman armour. LOL
Bob
Hi,I believe it's the second or third day following your Ablation...l hope all is well and smooth sailing .I shall be following your recovery and keeping everything crossed for you...Carol x
So pleased for you. Take care and rest plenty for a while. Was it a Pulmonary veins ablation? Thank you for sharing. Where did you have it done and by whom. I am on the waiting list for an ablation too.
Hello Iris -- so pleased to hear that everything went fine for you. Having had my 1st two ablations under sedation & the 3rd one GA I can say that you do recover much quicker with the former.It's such a great feeling when it's all over successfully , isn't it? On a lighter note , when my EP came to see how i was after my 1st ablation I had felt so elated to come through it all in one piece ( not to say alive! ) that I said that' I felt like I had just given birth' ! He gave me a funny look & said that he had never heard that before but said that he could assure me that ' nothing like that went on'!
Thanks to all for giving me a clearer idea of the actual incision site, etc. The lidocane I had last year for the interstim device implanted was in the buttocks and there are a lot of muscles there, that might be why it hurt so much. Plus, I had been given nothing else to relax me..not even a Xanax
Again, I would tell all, learn to ask for what you need/want - regardless of their opinion with the exception of something which could alter the outcome. There is NO reason for us to suffer - we already do enough with this darn AF! Good luck, hope the interstim helped!
Hi Iris, what a truly great post. So positive but factual and reassuring! I found great comfort in this as one soon about to undergo my first ablation for persistent AF - 2 weeks on Monday, (14th April 14). I am more than a little apprehensive (being the worlds greatest coward) as the day draws nearer. I just hope, having had to "psyche myself up" for the last 5 months, it all goes as planned following the pre-op this coming Thursday. I will be having a GA so hopefully will not know too much about it, but have to overcome the anxiety attacks before I can get to that stage.
Hope I can emulate your experience and wish you every success and a speedy and complete recovery. Will post my experiences in due course.
You are not a coward, what we have all come through already to get to this point proves we are a very brave lot. It is a long time to wait and ponder. I decided and then had 4 weeks of anti-coags before mine... less time to fret! Don't hesitate to ask any questions. Keep us posted.
Hi Iris, well ablation day is just 8 days away, and the anxiety is now kicking in, good style. Had the pre-op stuff last Thursday, at which point I think the reality started to finally kick in! At least I am first on the list for the day, so hopefully won't have to lie around "brooding" for too long. Need to present myself in admissions for 08-00 hrs so hope to be "done and dusted" by early afternoon.
Oh how I know that so well! I had booked clients up to the last minute the day before. As I went into a slow "melt-down" I had to cancel each client one by one until I watched the day (and the income) slip by. I think I realized I wasn't going to have to be so vigilant and gently let go. Someone else was going to be vigilant - if only for a few hours!
Truly, think of it as plumbing and a muscle. The heart is a strong muscle (as we know all to well). Can you imagine being worried about a slight burn to your thigh? It worked for me! Keep us posted and don't hesitate to write as often as you want feedback and good wishes - it helps. all the best Mallet-head!
Hi Iris, I've been visualising your description of "plumbing and a muscle" It de-mystifies things a lot, and - no I am not concerned at all about a small burn on my leg. My mind is tonnes lighter using this analogy, thank you.
Hi Iris, I need to present myself at the hospital at 08-00 hrs on Monday 14th April. At the pre-op the nurse clinician said I was first on the list for the day, so unless anything unforseen crops up, I should be all "done and dusted" so to speak by early afternoon. I have to go for an INR test at the GP tomorrow am, as it was running a little high last week. Fingers crossed!
I don't know if this would help, but I have been following a woman who has a site with wonderful free meditations... heart meditations. It is so literal for us!
She has been a calming inspiration for me - and I am not good at meditating! She has short and long ones, and her talks are terrific. I love the Duck Meditation... when I was a bit hesitant I went into Duck mode! bobbing with the waves instead being beat up by them... sounds like our hearts!
Duck Meditation (Anon)
Now we are ready to look at something pretty special It is a duck Riding the ocean a hundred feet beyond the surf As he cuddles in the swells.
There’s a big heaving in the Atlantic
And he is part of it.
He can rest while the Atlantic heaves
Because he rests in the Atlantic.
Probably he doesn't know how large the ocean is And neither do you But he realizes it somewhere and what does he do, I ask you?
He sits down in it.
Duck Meditation.
He reposes in the immediate as if it were infinity Which it is.
As with meds, and meditations, all personal in outlook so if this doesn't do anything for you just hang in there... your almost home! (where the heart is).
Hi Iris, thank you for the link, I'll have look at it tonight. The duck analogy is a good one! I guess it says that any amount of worrying is not likely to have much effect on the outcome of any situation we find ourselves in.
I preferred the duck to friends (with good intentions), saying "you'll be fine"..... I am fine, BUT, if they had any idea as to what leads us to this point and an awareness of how much courage it takes to do this! You have been tempered like steel already by the AF.... the ablation will just be the next step to soften some of that steel!
Hi Iris, had a listen to a couple of the guided meditations on Tara Brachs' website last night, relating to Mindfulness and "staying present" and found them really useful. I will have to work my way through more of them in due course, but these are definitely in line with the stuff I have read on Mindfulness, and will be a great help, especially as I am somewhat prone to bouts of severe anxiety.
Wonderful, I fell upon this site awhile back thanks to a friend and we have been going back and forth with which ones we like best. I can say I used the practice prior to, during and post surgery. Quite helpful.
Wish you the very best mallet-head nd look forward to hearing your experiences. I didn't have much time to worry as my appointment was only made 6 days before. I had missed one 6 weeks earlier with a low INR.
My first ablation was very swift - arrived at 7.30, filled in forms, cannula in arm, no delay and was down to the cath lab at 8.30 and home later in the day. No time to ponder.
Second one had a significant wait. Arrived for eight and was still waiting at 2. it was a long, very long, thirsty morning. I was whiffled by the consent form. Suggest anyone finding this difficult might like to have something to occupy the mind, like a humorous and uplifting look back over the years. What's the best holiday you ever had? if you had one day of your life again, which day would you choose? Who are the three people you would most like to be stuck in a lift with? Things like that. Is there some little book of thoughts before an operation? Fearing slightly that I might be enjoying my last hour of able life, i penned a sloppy little note to my husband. Watching Bargain Hunt on the TV did not quite seem the best use of the time. Of course, it went fine, just as, deep down, I knew it probably would.
HI Relim296, thanks for sharing your experiences. Hopefully my first one (in 8 days time) will emulate your first experience. My INR is running a little high (3.5 last week) so they told me to recheck it mid week and phone them if not in range of 2 - 3. Presume they will decide on the next result whether to proceed as planned or not. My warfarin has been steadily reduced over the last 2 weeks so fingers crossed it will be in range. As I posted in a reply to Iris above, anxiety is causing me a major problem so I really don't want to string this out any longer than necessary. Got some diazepam (okay'd it with the admissions clinician) if necessary but don't really want to take it.
That's sounding good, get them while they are fresh! I think there was something that caused a delay when I had mine last month. My INR was 3.5 on the day but didn't seem to be a problem. I think stress may have pushed it up. See if you can have some little treats this week.
I haven't noticed anyone here saying they wish they had not had an ablation - seems quite the opposite. Hope it goes speedily and effectively for you.
Thanks Relim296, I'll keep all posted after ablation on Monday. My INR has reduced back into correct range as of this morning, and expect everything to proceed as planned now.
All the best! We are so lucky today to have the facilities available to us to reduce the impact of AF, hopefully, and to get our lives running more smoothly again. Hope it all goes well for you. Have a good weekend - you are about to take a step forwards.
Thanks for your information. I am having an ablation next Tuesday. My biggest worry is being conscious for the TEE...do you remember that? I had to "swallow" a scope for a different procedure years ago while consciou, and I am still traumatized by that memory 15 yrs. later.
Were you conscious for any of the actual ablation? I am told I won't be, but I am not sure whether or not to believe that. How long afterwards do you have to lay flat and still? I was also told the procedure the hospital uses that I am going to is called "cold ablation" or something like that, and I understand the approach differs a bit from the other type. One difference, I understand, is that they use veins in both legs. I'd like to be "out" for everything, I really don't want to remember anything about it.
Good news, that you are on your way, all that said I certainly understand your apprehension - it is normal. I can safely say that I wouldn't hesitate to go again, now that the mystery is over! It really is the unknown that is bigger than the actual process.
I was given a quick sedative for the TEE and then was vaguely awake for the procedure, I did feel things and remember watching the ECG and mapping screen until they briefly (12 minutes) deep sedated me for the cardioversion - of which i felt nothing before or after (no red patches either on my skin). I was lying flat for about 5 hours post op. No pain, not difficult.
In terms of cold ablation, I assume you are having a cryo-ablation. I had radio-frequency, each doctor has their preference, if you like your doctor, don't hash over what type too much. I'd let them do what they do and know best! In terms of two veins, other than a tiny tiny discomfort if I literally pushed on the site of the groin puncture - I had NO pain and no trouble after the surgery. My friend who accompanied me was on the phone the next day telling her friends, "you'd think she'd been to the hygenist to get her teeth cleaned the way she is walking around". I was more tired than I'd expected but in no way exhausted.
Ask in advance about the sedation for the TEE, so you can cross that off the list! Get all the information that could possibly put you more at ease in advance. If they told you that you would be getting a general anesthetic then you will, they wouldn't "play" with that type of information!
Glad that you had a good experience. I will find out next week if I am having my 4th. The other 3 were all around 7 hrs and I could not have coped without a GA. First one resulted in a groin haematoma and permanent damage to the femoral nerve. But I will have another if recommended as being without AF was marvellous.
Thanks so much for your detailed description, which has calmed most of the niggling concerns that I have 3 weeks prior to my ablation, including not sleeping during the night in hospital i feel awful if I don't sleep anyway so will definitely avail myself of any medication offered! I am still wondering about lying still for 4 hours and have been told by a medic that it is possible to get a pressure sore just during that short period, although hopefully that won't happen! All the best for your recovery and keep us posted.
I have a hunger for information, so I wrote it as I had wanted this type of detail! Glad it could help, don't hesitate to ask ANYTHING else, on this post or private! Feels so much better going in having had doubts and questions addressed. By the way, I had no trouble lying 6 hours and I was dreading it as well. I wasn't put completely flat as often said, head and back were raised a bit, and it was fine. I was tired! It is so nice having behind one that there is a certain peace that prevails! Take care, let us know how it goes. Keep asking/posting if it helps!
Thanks so much for your experiences regarding Ablation which I found very interesting - especially as I am undergoing an Ablation myself on 19th June and feel very apprehensive about the whole thing. Thank you again and best wishes for the future.
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