FAQs - Ablation

[AFAssociation1]

Ablation, before and after

Q) What is it like?

A) To start with the procedure takes place in a catheter laboratory not an operation theatre and is not an operation in the normal sense. You will find that this is a busy environment with lots of people wearing lead skirts and aprons to protect them from the x-ray machinery which they use to see into your heart. There are lots of screens on the wall next to you with pictures of your heart and what is going on. If you are only under sedation you may find it interesting to watch this and marvel at the skill of the Electrophysiologist and team. You will have a small incision in your groin where the catheter is inserted and they move it into your heart and make the burns to create scar tissue to stop the rogue impulses. This does take a long time, sometimes up to five hours but the sedation should make you sleepy and the time soon passes.

Afterwards you will have to lay flat and still for another few hours to make sure that the entry wound has sealed but you will be allowed sips of water. After that you will be able to sit up and later have a shower and a meal. You normally stay in hospital over-night and then will be allowed home with a relative or friend the next day. You should rest completely for a few days. Many EPs say you can go back to work after a few days but I honestly think that

two weeks is a good recovery time in the first instance.

Q) Do it now or wait?

A) Most Electrophysiologists think that early intervention by ablation is the secret to a satisfactory outcome for patients with AF. It is easier to ablate before the AF has become permanent and before the heart has produced too many rogue pathways.

Many patients feel that ablation is a risky and serious procedure but experience has been that the benefits outweigh the risks in most cases. I have yet to meet a person who regrets having had an ablation. Most people seem to find a time when they move from not wanting an ablation to accepting that it is right. The secret is not to wait too long.

Q) What can I expect after an ablation?

A) When you return to the ward you will have some discomfort from the entry wound and this may develop some colourful bruises over the next few days. This is normal. A small amount of pain in the chest area is also normal but this should pass after a day or so. You will feel tired and sleep a lot for the first few days especially if you had a general anaesthetic.

Although you may be told that you can return to work after a few days it is better to take time to recover. You will not be allowed to drive for a few days and should have somebody with you to start with. No heavy lifting etc but you will have a do’s and don’t sheet from the hospital in most cases.

You will probably experience some short runs of AF and a few other arrhythmias but don’t panic as this is normal. It takes three months for the scar tissue which blocks the rogue impulses to form and you may have breakthrough episodes in that time. Results are improving along with improved methods of performing ablations but be prepared that you may need a second or even third procedure to fully sort your complex heart.

For copies of AF Association's publications regarding ablation, please visit:

atrialfibrillation.org.uk/p...

[SuzieA]

Thank you for this report it is the best explanation of ablation that I have ever had. I go for my first one later this month and feel that I now know what is to happen before and after.

[wpw62]

Very informative and most welcome as I have just got my date for my ablation on11th July. Well done.

[Hidden in reply to wpw62]

Hi, would I be correct in saying that your waiting time from consultation to ablation is about 12 weeks?

[wpw62 in reply to Hidden]

No. I saw the consultant in January. He said the waiting time would be about 18 weeks. Everything happened as he said it would. I had a CT scan the started warfarin in March. After having got my INR levels stable I rang for an appointment 3 weeks ago and was given 11th July so not much longer than I expected, only about another six weeks. Just counting down the days now.

Where are you at on your journey?

[Hidden in reply to wpw62]

Hi, so altogether you've had to wait 6 months? I only saw cardiologist 5 weeks ago today. I just wish they'd tell you how long approximately you will be waiting as I work internationally and offshore for a minimum of 2 months in the oil industry and therefore can't just get on a helicopter to go to hospital when an appointment letter arrives through my letter box. I can't afford to not go to work, so if they send me a date and I'm away in the middle of the ocean, then not only would I miss the appointment, it would also stop someone else having a cancelled appointment, because I wouldn't be able to read my mail and cancel my appointment. So frustrating. When you have your initial consultation, they should give you an idea of when your follow up appointments will possibly be, so that people who may be in the same position as myself can make long term plans to accomodate appointments.

[wpw62 in reply to Hidden]

Yes it is frustrating. I was told at my initial consultation that it would be 18 weeks. I was given 8 weeks notice for my ablation date. Have you seen an EP specialist or a cardiologist When were you diagnosed ? I was not happy with the cardiologist at my local hospital He fobbed me off with tablets by letter. Not even a visit to talk things over so I went private with ablation on NHS. Good luck. Sometimes you have to keep pushing to get things done

[Hidden in reply to wpw62]

I was diagnosed in June 2012 with PAF., and am asymptomatic. I don't have many incidence of AF., my problem is it could interfere with me getting a medical for the job that I normally do, so want to get it sorted. I had an appointment with an EP., but when I got to the clinic I saw another guy and I don't know whether he was an EP., or cardiologist, but discussed with him cryo ablation as I'd been refered by a cardiologist. I got the distinct impression that the guy was trying to put me off ablation because first he asked how old I was and then he told me it might not be successful. I told him I needed to get a private medical for my work and that AF., may be a problem to me to get my medical. I had to be forceful in my dealings with this guy. So now I'm waiting to hear what they intend doing, but I'm going to phone them tomorrow and ask for specific time frame as I can't sit about for months just waiting for them, I need to be working and as I work overseas for a minimum of two months at a time offshore I can't waste valuable time not earning money. So frustrating not knowing what's happening. I'm 65 y.ears old and therefore time isn't on my side with regard to waiting months for an appointment to come along. I get the impression that they think everybody who works has a job down the road from their home and can be at their beck and call all the time.

[Jackiejacks in reply to Hidden]

Hi.

From my consultation to ablation was 8 days. Very very fast indeed.Kings, fantastic bunch of people dealing with me. Spent one night in hospital. Hardly no pain. Just black/blue top part of leg from entrance site of groin.

[CDreamer]

Just one comment, after I left hospital after ablation I was informed in writing that DVLA insist that you cannot drive for 7 days following ablation. Not that I wanted to anyway!

Also it was all much, much easier than I thought it was going to be and at present I am AF free. I hope that it goes really well for you both.

[Barb1]

Another comment - sometimes they take longer than 5 hrs. In fact my shortest was 5 1/2 and longest 7 1/2. Just in case you have relative waiting who may be worried!

[Mrspat]

Just one comment. Is there any information available about the procedure being carried out via a non-groin route and/or under general anaesthetic?

[rosyG in reply to Mrspat]

I haven't had ablation but two members of this forum have mentioned that they were able to communicate with the EP doing their ablation in a way that was helpful at the time- they had the sedation but not general anaesthetic- I have read it also depends on availability of anaesthetists, and also that if you have a GA the oesophagus is stabilised because of the GA intubation so this might be an advantage- difficult to know what's best???

[Loo53]

Thanks I am due to see my cardiologist for this procedure next month and appreciate the explanation

[Hidden]

Hi,

My experience with AF started in January this year, (2014). However, in reflection, I was suffering with rapid HR, sweating for at least twelve years, but not going into AF.

Yesterday, being Sunday, was release from hospital after a bout of AF. I was electrically revived, if that's the lore and then released the next morning.

I am extremely at odds with all the medications us souls have to endure. I asked the attending cardiologist about ablation as an option to treatment, which he wasn't very receptive about. Can someone explain why he should feel that way and anything more that might be of help?

I am 52 years old, and for the most part, very healthy.

If this is a viable option, then I would like to pursue this sooner rather than later.

Thank you all.

Martin Nolan

[Hidden in reply to Hidden]

Hi, I went to see a cardiologist, who refered me to MRI., hospital in Manchester. I am 65 years old, very fit and active and still want to go to my regular type of work, but that requires me to have an HSE., recognised medical to allow me to work. The cardiologist I saw told me that after ablation some people go back into AF., I told him that also some people don't go back into AF. I got the distinct feeling that he was trying to talk me out of having ablation because of my age. When I was insistant and told him I had to work away from home and offshore and that logistically I couldn't just go to hospital or the doctors if I had a bad attack of AF, he asked me how long I intended to go on working for. So I got the impression that it was all cost and age related, but if I was an abuser of my body with drugs, cigarettes or alcohol or obese then I would have no problem getting funding for my bad life style choices, but because AF., is not considered life threatening and they think that the cost of treatment outweighs the return the government will get on you from a financial point, then I'm sure the unwritten rule is don't spend money on people unless we get a return on the investment. If you had private medical insurance and your premium covered you for 1,000,000 pounds, then you know how much you can get treatment for, but with the NHS., these dicisions are made by area health fund managers, who get paid by how much they can save the NHS. As someone has said previously its a lottery as to whether you can get funded for treatment, unless your a low life, whose abused themselves.

[Hidden]

When people blog about ablation, some people do not mention which type of ablation they are having. If I'm right, cardioversion is classed as ablation, which I believe in many cases patients eventually revert back into AF. Also cryoablation is supposed to be much more efficient than radio frequency ablation, with much better % success rates for stopping AF., on a permanent basis. Would appreciate anyone elses opinion on this.

[Kjporten in reply to Hidden]

I am on a wait list for the balloon cryoablation. I would like to hear if anyone has had this as well.

[Hidden in reply to Kjporten]

Hi Kjporten, I've done a lot of research on this subject, being also unlucky to suffer midly from this condition. I recently asked for referal to have laser ablation in London, where I do not live. Then I got to see an EP., at Manchester Royal Infirmary. I told him that I had asked for a referal to another hospital to see about having laser ablation and he went to see the head Electrophysiologist at the MRI. He came back and told me that cryo ablation was as successful as laser ablation, so I left the consultation telling him that if it was as successful, then I'd go for that ablation. I went home and phoned the London hospital and spoke to the EP's secretary and asked her if anyone

of the specialists at her hospital could confirm that cryo ablation was as successful as laser ablation procedure? She called me back after 10 minutes and told me that the consultant she asked had confirmed that cryo ablation was as efficient and had the same % rate of success as laser ablation, which is the latest procedure for ablating the pulmonary vein, which I presume, if your in PAF., having an excellent first time successful outcome. I believe the success rate for a one off ablation is average of 80%+. I myself want to try this as I want to try to get off popping pills as its not suitable for myself to be tied to the GP's or hospitals as I have to travel extensively worldwide and for long periods with my employment.

[suebel in reply to Kjporten]

hi yes i had one in june of this year at the same time i also had a pulmonary vein isolation, it was done in the cath lab and i had sedation and pain relief. the whole thing took 2 - 3 hours i was awake but very sleepy and it did not seem like it took so long. I had to lie flat for a few hours, once i had been up and the nurse checked my groin to make sure there was no bleeding, i had tea and toast and went home same day. i was very tired for a few days and then started with breathlessness i was readmitted to hospital and was told that there had been some disturbance of my phrenic nerve which passes through the diaphram. this has now resolved itself after a few weeks and i am now feeling the best i have felt for 3 years. I have not had any AF since the ablation and have been able to stop taking beta blocker bisoprosole and also now stopped the flecanide which i am glad about. I had a stroke 3 yr ago and it was then i was diagnosed with AF i had lots of hospital stays felt really ill and had 3 cardioversions thankfully i have had a full recovery from the stroke my speech has come back and i take riveroxaban anticoagulant which protects me from stroke. It has not been an easy road but at last i can see the light and look forward. i attended my EP clinic the yesterday, the ECG was fine they are very pleased with me i dont go back until next june which will be a year from the ablation, this condition is complicated and different for everyone, but i would recommend being advised by your EP and if he recommends cryoablation i can only say i am glad i went for it and looking forward now i am 71 years and walking and gardening in moderation of course and planing a holiday next year as i havnt had one for 3 years. I feel so much better and it has been worth it for me.

[Hidden in reply to Hidden]

A cardio version is not an ablation. This is when an electric current is passed briefly through the chest wall to shock the heart back into sinus rhythm. When people refer to an ablation they normally mean radio frequency catheter ablation

[Hidden]

Can anyone tell me what are the average waiting times for an ablation, after first cardiologist EP., consultations please?

[leader777]

Hi was interested in reading about ablation and the time it could take my EF.who I met recently informed me it would take one and a half hours under GA..i was very concerned about having a GA.as I have insulin dependent diabetes and Addisons disease wonder now whether to proceed Hazel

[Neil_69]

When and what reasons mean they cannot do an ablation ??

[Barry24]

I've had 3 ablations and if l could turn the clock back l would in a heartbeat.

[judybrowneyes]

Why is that Barry ?