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: