I had cryo PVI yesterday morning and just wanted to share my experience, in the hope it will help others through the process and allay some fears.
But firstly I wanted to sincerely thank the contributors to this forum. Although I haven’t posted anything until now, I’ve been reading all the posts for the last few months and they have given me a great deal of support and information, so I can’t thank you enough. I don’t mind admitting that I had felt very fearful and nervous of having this procedure carried out.
So here’s my go at hopefully giving others some reassurance about the procedure itself. In general, I think the months of waiting is far worse than the day itself. From my initial GP referral (through Choose & Book) to the date of my procedure was about 8 months. I’ve had AF on and off for the past 8 years and it had started to become more persistent this last year, so it was decided PVI would be the best treatment for me. Up until that point I’d only been taking an aspirin/day and self-managing my symptoms, but as the AF became more persistent I had become exhausted. So approx. 10 weeks ago I started on warfarin in preparation for the PVI. At first the warfarin made me feel light headed but my body eventually adjusted to it and I managed to keep my INR level between 2 and 3 for the 4 weeks leading up to the procedure.
So yesterday was the day, and I’ll try and give as much info as possible.
I checked into the hospital at 9am and was taken to the ward. The EP consultant came to see me at 9:30am and advised that I was first in. He explained what he was going to do and what the risks were. I got into my gown, etc and had a cannula fitted in my hand. The anaesthetist then came for a quick chat with me and I walked with a nurse to the operating theatre. There were 7 people there (the main EP, an assistant EP, an anaesthetist, 2 nurses, and 2 technicians who were sat looking at computer screens). I was asked to lie down on the bed and a 2nd cannula was put into my other arm. The team were very friendly and joking with me to relax me and said I’d start to feel a bit drowsy. After about 5 seconds I was totally out (I had general anaesthetic).
The procedure lasted approx. 2 ½ hours. The TOE was inserted whilst I was under anaesthetic. As previously advised by the nursing staff, I woke up in ICU and remained there for about 4 hours, and later had some lunch and a drink. I didn’t feel any pain when I woke up, just a mild heavy feeling in my chest. My 4 pulmonary veins were isolated using the cryo balloon technique. The EP had explained previously that the entrance to the 4 veins would be individually frozen for 4 minutes (twice) to form scar tissue which would break the electrical pathway of the signals causing my arrhythmia.
I was then taken back to the general ward. It was such a relief to be in sinus rhythm again. I had a few ectopic beats per hour but I was told this was nothing to be concerned about. I stopped in overnight and had a mild headache and this slight heavy chest feeling throughout the night, but no other discomfort at all. No pain at all from the incision points in the groin.
At 5:30am I had my blood pressure and pulse checked. At 8:30am I had my breakfast and then at 9am I had my cannulas removed, had a wash etc, got dressed and got a lift home.
Now just taking it easy for a few days and see how it goes.
So to sum up, on the day you just go with the flow. You don’t have to do anything, you’re in great hands, and before you know what’s happening you’re in theatre and then you’re back in the ward and it’s all over.
I hope this info is of help to others currently waiting for their procedure, and many thanks again to all those who regularly contribute to this forum, as it has certainly helped me tremendously.
My follow-up with the EP is in 2 months, so fingers crossed I stay in rhythm
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Paul66
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Coming to the forum and making a post like this to reassure people is brilliant, and it's these sort of posts that make the most difference, as everyone wants to know "what's it like"
I haven't had an ablation, but I am told that you should expect some weird beats for a while, and that it takes a while to settle down and the scar tissure to form properly.
Do take it easy, we often underestimate just how much a general anaesthetic takes out of us, but it sounds like you got great treatment.
I hope you keep well - thank you for such a descriptive post....was just like reading a diary entry. I haven't had an ablation procedure but will bear in mind your reassuring comments. Regards Patricia.
Paul thank you so much for your detailed post. I am counting down the weeks to my ablation and to read your post is very reassuring. I am having a GA and was getting concerned to say the least. I hope you make good progress and keep us posted. Once again thank you so much for posting. Cathy
Waiting is by far the worst part of it all; it was always in the back of my mind. On the actual day everything seems to happen so quickly and its all over before you have time to think. I had mixed views about GA or LA, but I'm pleased I had GA. Yes, I felt a bit groggy when I woke up but it soon wears off.
Well done Paul and again thanks for the account which is pretty much as I remember mine. The most important thing now is not to overdo things. It takes three months for the scar tissue to form and a lot can happen in that time so don't worry if you get a few break through episodes or funny beats. I was told do nothing for the first week and a not a lot more for the second and then ease yourself back into normal life. NO heavy lifting of course. Others may tell you they went back to work quite quickly but from my considerable experience a slow gradual recovery is best. Lest face it , the GA takes AGES to clear you system. I had terrible memory lapses after all three of mine. Killed two kettles in that time ! lol
Many thanks Bob.....great advice as always. Reading your no nonsense advice and sense of humour were a great help to me leading up to my procedure. Thanks again!
I have finally been booked in for what seems like a double PVI/AF flutter "procedure" ,as the cardio electrophysiologist I saw last week told me. Must admit have been worried (actually very worried!) and do feel like a real wimp, fretting over what a general anaesthetic will be like mainly( wish I hadn't mentioned it at work coz' got the negative experiences before the few positive ones!)
Your experience is what I really want to hear, so thank you. So glad yours went so well.
I'm pleased you found my experience helpful. You're certainly not a wimp to be worried about it. I was also very worried, as I'd never had a general anaesthetic before either, but I found that the actual waiting for the day of the procedure to arrive was the worst part of the whole process, as on the day everything happens so quickly and you'll be in great hands.
Hi paul 66 wow you make it sound so bearable I am a wreck waiting to have ablation on second of july I vasilate between proceeding and not I was surprised you woke up in intensive care a bit frightening my EF.has told me it will take 1.5 hours and short down time, keep in touch i will follow your recovery with interest well done .Best wishes Hazel
Do be encouraged, Hazel. I think Paul's summing up - third paragraph from the end about going with the flow and having nothing to do - puts it all neatly in a nutshell.
Many thanks Hazel and Rellim296. Most people I've spoken to who have been through an ablation have had mixed thoughts prior to the procedure. When their AF is particularly bad they want the ablation asap, but when they have a good period they then start to think that maybe they don't need an ablation after all. I went through this thinking for years, and it's purely down to fear. I also think there's a fear of not being in control during the actual ablation procedure, which again I think is a natural feeling. I just tried to let go of trying to control the situation and let the experts get on with their jobs. Easier said than done, but on the day it all goes so quickly and they are very used to putting at ease patients who are naturally worried.
Regarding me waking up in ICU after my procedure, thankfully I had been told prior to the procedure that this is what would happen. It's just their standard procedure. It may not happen at your hospital.
In general, it's 2 weeks today since I had my PVI and I'm feeling really good. I think it probably took me about 10 days to totally get over the effects of the general anaesthetic, as I felt dizzy and a bit 'not quite with it', and very low on energy, needing lots of naps after gentle exercise. Apart from the odd ectopic beat, my heart has been regular since the PVI and I'm now continuing to slowly build up my fitness again.
So, I wish you all the best on the 2nd July. You'll be in great hands, so just try and go with the flow
Hi Paul thank you so much for your reply , was pleased to hear the visit to ITU is standard you are quite right about control issues I am insulin dependent diabetic and also have Addisons disease and am able to manage these conditions myself but the GA gives me lots of concerns I am also a nurse which is not helpful guess I have to trust the process as you said I have just read EPs credentials he was very confident during my appt. with him. Can you tell me what PVI stands for as there seem to be different types of ablation ? I should have asked EP. what procedure I would be having .Best wishes Hazel
Hi Hazel - apologies for my delayed reply. PVI stands for pulmonary vein isolation. For my PVI procedure the EP used a cryo balloon inside my heart to form scar tissue around the entrances to the 4 pulmonary veins (by freezing instead of heating) where AF is usually triggered from. This scar tissue prevents these rogue electrical signals triggering extra random heart beats. I'm certainly not an expert on these things, but have found plenty of information on the internet, especially youtube. I got the impression that more EPs are now using this cryo technique, but I suppose it depends which areas of your heart are triggering your arrhythmia.
Hi Paul thanks for explaining what PVI. stands for all sounds very complex,did you know what kind of procedure you were going to have prior to op.my EP has not said very much except he will do the procedure in 1.5 hours and home next day guess I will contact him via email and ask more questions ie.what part of my heart is triggering of the arrhythmia ,I am so pleased to hear your op. seems to have done the trick for you ,as my op gets near I am getting reluctant to proceed .3 days with no AF.and the Pollyana in me feels it wont return but have been thinking that for 3 years with it getting gradually worse and more aggressive .best wishes Hazel
Yes, my EP explained to me at my appointment before my PVI was booked. He then explained in further detail on the morning of the procedure.
I went through the same feelings as you, thinking I maybe didn't need it doing when I had a few days without AF. The only thing I can say is that I'm really pleased I went through with it, and feel a sense of relief that its now over and I don't have to worry about it anymore (hopefully!).
But obviously there's only you who can make the decision whether to go ahead or not.
Hi Paul. I've only just come across your post - it's very informative and useful. I had my ablation about a month ago now and like you, I'm hoping the AF Has gone away. Good luck.
Many thanks Therealsue. Hope you are doing well after your ablation. I've just heard I have my follow-up appointment with my EP on 22nd July. Heart seems to be behaving itself at the moment
Paul. Reading back, like me, you seemed only to start warfarin in the lead-up to ablation. How long will you be on warfarin for? I'll be on it for at least another 4 months until I see my cardiologist again, but thereafter, I've always assumed I'll stop. However the consensus on this site seems to be that we should continue with it. I'm not overly fussed either way, although I'm would like not to have to to watch what I eat and drink (I have to say though that I'm not as strict now as I was pre-ablaion) I'm just wondering what your views are or what advice you've been given. Sue
Hi Sue - similar to you, I was told that I'd be on warfarin for up to 6 months after my PVI and then if my AF was no more I'II come off the warfarin altogether. I'd prefer to be off it at the end of the 6 months if at all possible, but will go with the EPs advice. I'm also the same as you regarding diet, in that I'm not as strict with my diet now I've had the ablation, but still trying to avoid the foods very high in vit k. I'm now on 3 weekly blood tests as my INR is now stable, whereas before the ablation I was on weekly blood tests. When's your follow-up EP appointment?
Hi Paul. I had my first follow-up last Wednesday. He seemed fairly happy with what I told him and reassured my that the odd wobbles were ectopics and not AF. Since then I also had an obvious missed beat yesterday and then another about 15 minutes later and then all was good, so I'm hoping that they weren't mini AF episodes. My ECG was fine too. Like you, I won't be eating a large plate of kale any time soon, but I put quite a bit of parsley in a salad recently. I'm on 2 weekly INR'S at the moment - I had a bit of fluctuation around the ablation time, but prior to ablation it was weekly and it seemed stable. I did stop drinking anything in the lead up to ablation as I wanted to maximise my chances of getting a stable reading quickly - it still took 5 weeks to get in range though. I've been having the odd glass or two of wine in the last week or so and I don't seem to have suffered any consequences, so I'll carry on like this really until I'm told otherwise. I have absolute trust in my EP/cardiologist, so In the end, I'll do whatever he advises. Do let me know how your follow-up goes in July. Sue
I have just reread your posts as I only have two weeks to go to my ablation. I have been getting more worried about it and now realise that it is because I won't be in control. So yes as you say I will have to go with the flow on the day and leave it to the experts. I have had complete confidence in my EP Specialist since I first met him. Hope your recovery and good health continue
Many thanks Cathy. To be worried is very natural. From our point of view it's obviously a major event, but from their point of view its a routine procedure and they are truly excellent at what they do. I'm sure having 100% confidence in your EP will help you. Just let them get on with it and experience the experience Take care and let me know how it goes. I'm certainly pleased I had mine done.
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