Swallowing a balloon to have the ablation?

I am having heart ablation in two weeks. I just saw in an answer to another question that that person had to swallow a balloon in order to monitor the esophagus during the procedure. In a different procedure years ago I had to do that (had to be conscious to do so) and I still remember that as being one of the most awful things I've ever experienced. Is this required in all ablations? I've never seen it even mentioned before.

12 Replies

  • My very limited understanding is that it is only required for certain types of ablation such as cryogenic or the new laser ablation. It is because it is much easier to burn through full thickness of tissue and then damage the esophagus which then may cause a fistula which is a very nasty complication that you really don't want. The balloon measures the temperature which is an indicator of the burn thickness?

    As far as I can tell, this is not required for RF ablation as the EP's have more practice with these catheters and they can control the thickness of the burns more accurately, too much and tissue may not recover, too little and it will not scar. I wasn't required to have that procedure with either of my ablations.

    Does sound a very unpleasant experience, sorry you had to go through that but hope the ablation was successful for you so that it was worth it in the end.

  • Yes, CDreamer is right. It is to avoid burning a fistula between oesophagus and atrium. I am almost sure it isn't ever done with a routine ablation.

    I chose a laser ablation because it was offered and a camera is used as well (via the femoral vein) and it seemed a good idea. I knew that swallowing a thermometer would be part of it. It didn't have a balloon as far as I know. It was quite small to look at - thinner than a pencil, and just a flexible tube.

    Have shortened this as I think I put too much in.

    Good luck with your ablation, regalone. It is a way of seriously improving one's health, and I am thankful such technology and skill is available to us.

  • turns out I will have to swallow a thermometer, since it sounds like you've experienced that can you tell me if it was difficult? The scope I had to swallow years ago was very large and had to go through my stomach to the bile duct, and I had to be conscious, and it obviously traumatized me as I still remember it. I still remember them yelling at me to swallow. Later I've had two endoscopies, but was not conscious (or at least don't remember that) and getting the scope down was obviously much easier. I look forward to your reply. I still have two weeks to stress about it.

  • Well, it was not so much difficult as strange and unfamiliar. Nothing like your awful experience. They froze my throat with some stuff that I have to say did not taste at all nice - bit like bananas mixed with something a bit peppery, and then the throat felt as if it was not there, which was weird. This lack of sensation stops the gagging reflex. The thermometer itself is very small, don't worry - the tube is thinner than a pencil and flexible - a bit like the wire I use to connect my camera to the computer. 3mm? Goes via the nose which is Ok, doesn't hurt, and then comes the swallowing bit. Throat does not feel its usual self. It was as easy as drinking from a cup is when a dental anaesthetic has not worn off - something not right about it and my throat less obliging than usual. Managed to swallow several or many times by thinking about making it happen. There was no yelling, not from them and not from me either. Don't remember wanting to yell anyway! There was lots of encouragement - told me I was doing fine, which I think may have been slightly inaccurate. It felt odd, very odd, but did not hurt at all. Peculiar sensation. We got it down, and that felt strange. They were very kind. Had no sedation to start with, perhaps they gave me some, don't remember feeling fuzzy. Would I do it again? Yes. Do not have any memory of anything after that, which is a pity really as there were screens to look at.

    I didn't have long to stress about it - heard on Tuesday it would be the following Monday, providing my INR was still in range, which it was. Was confident that it would not only go OK but would be a big step forward. It has a very high success rate and dire complications are less than 0.something per cent. Hope this is helpful.

  • Thanks so much for your speedy response and clear explanation. I am having a difficult time accepting this...and the nose part sounds awful, although you indicate that wasn't difficult. Did it take you a lot of attempts to swallow it? In the earlier procedure I had it was the staff "yelling" at me to swallow, I couldn't say a word because of the big scope in my mouth of course. I was a bit woozy so they must have given me something before I had to do the swallowing, but I do remember it vividly. Can't remember if they gave me a spray for the throat but it makes sense that they had. One of the reasons I am so reluctant I think is because I rarely feel my AFib and it doesn't effect my daily living. It's only because the 14 day heart monitor showed that I am in AFib 25% of the time and that my heart stopped for 8 seconds that my EP says I need the procedure. I suppose if I felt worse, I'd be more willing to proceed without thinking about the actual process.

  • I suspect you may have more AF a few months or years down the line as it does not tend to go away. It is certainly said that early ablation is a good idea. The atria, I believe, or at least the left one if not both, tend to get enlarged which isn't good. I was happy to go with my EP's advice. He offered the laser method. I thought the camera bit was a good idea and therefore opted for it, hoping I would manage the thermometer. We did in fact have two attempts. First time it must have gone the wrong way when it was a few inches down. I had I think been sitting up. They got me to lie on my right side and we started again. It had not been pleasant, I admit, as it felt so weird, but I could have said then that I didn't want to try it again. I felt I could do it Ok and it went well second time. Did NOT hurt, don't worry, nose bit was not difficult! Worst experience of my life was having a tooth that shattered extracted - didn't like the crunchy noise! Would rather swallow a thermometer any day. I've had no ill effects - nose and throat are fine. They have put me on Lansoprazole for a month to soothe any gastric disturbance. Haven't noticed any. Amazes me that so much can be done so painlessly. The two tiny punctures at the top of the leg have been no trouble.

    Hope you feel encouraged.

  • Hi , just noticed your question and as I was in exactly your position if worry a few days ago I thought I would relate my experience . I had laser balloon ablation 2 days ago and am niw home resting . I also wondered why I had to swallow a thermometer when some people obviously didn't ? It was explained to me that it was only used on laser ablation and was an extra safety precaution to ensure no burning if oesophagus and isn't necessary in other types of ablation. But as my cardiologist had this as his particular field of expertise and assured me it has a much higher success rate I agreed . My throat was sprayed and the tube put into nose no problem . The swallowing was a bit difficult because if being numb and it made if difficult to findmy swallow so to speak but not painful at all . No sedation till after the tube us in right

    place then the ablation went fine . I did have a sore chest and throat pain last night in fact it felt very sore and bruised . But I was told this is to be expected . But today I feel a lot better I rook co codamol to ease the pain and I expect to be feeling much better in a day or so . My doc says he is delighted with the way it went to fingers crossed . I couldn't cope with the daily episodes of AFib a day longer .so think positive and don't worry . Do it right and do it once !!! afib is usually progressive so the earlier the better so I've been told but I'm not a doctor . Ok hope this helped slightly and good luck try not to worry

  • No Regalone no balloons. What you read was about swallowing a thermometer when laser was being used. Never had anything like that in any of my three ablations.


  • Thanks to everyone who replied.....I guess I'd better pose the question directly to my doctor rather than fret about it for 2 weeks....not sure which type of Ablation they plan to use on me.

  • Regalone, ablation sounds much more challenging than I have found it to be. Would not have had a second one if the first one had been scary.

  • With a laser balloon ablation you have to swallow a thermometer , not a balloon.

    With a standard r/f ablation you do not need to , they will discuss options with you when you go in for the op.

    good luck

  • Had two ablations, one with sedation and one with GA, never been asked to swallow balloonx

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