ablation under sedation

Hi all.

I had successful ablation for flutter in June.

Unfortunately they noticed that AF perked up when they paced me.

Then I had a number of episodes

I always assumed that AF ablation was carried out under GA.

I had a TIA in Feb this year . Although my symptoms aren't as bad as I read on some posts, they must think ablation is best v drugs .

I was wondering why I'm to be sedated instead of GA.

The op for flutter under sedation did push the pain barrier and this is a bigger job.

Any thoughts ?

19 Replies

  • Hi, ablations for AF can be done under sedation or GA. It is somewhat easier for the EP if you are having GA , I understand , as you are completely still! However there will no doubt be other factors to take into consideration. I had my first two ablations for AF , lasting in excess of 4 hrs each under sedation .Most of the time you are ' away with the fairies ' & if you feel any pain you are able to indicate with your hand & painkiller is promptly topped up. At least it was for me. My third ablation for flutter was under GA . Recovery from sedation is very quick whereas GA I felt quite awful afterwards

    If you particularly want it done under GA you can always discuss this with your EP ,particularly if you found your simpler flutter ablation painful.


  • I had my ablation done under sedation. From what I can remember, there was one point that I think I felt some discomfort and I must have groaned or something. That was the only part I remember of the whole 5 hour procedure. My recovery was quick too.

  • I found sedation perfectly adequate and it all seemed pain free, but I can remember nothing except the first few minutes. As Yatsura says, away with the fairies!

    There is a view on the forum that ablation should be a last resort and other avenues, such as lifestyle changes and various alternatives, should be explored to see if they bring about improvements so that medication can be reduced. Others see ablation as a bold step to be taken before AF gains a firmer grip and symptoms become more severe.

  • Just read that coffee ( caffeine) consumption does not affect AF - but I thought it was a stimulant - I drink decaf coffee & tea whenever I can and don't drink to try to prevent any extra effects on my AF - I am in AF but do not want to aggravate it

  • Aggrivate

  • Right first time!!

  • Ha haha - thank you

  • I am due ablation for flutter very soon - low INR, then re call for mammogram stopped procedure - hopefully will have it done onMonday 27 October - though INR yesterday had peaked to 3.2 .... Anyhow .... Hoping it will sort that out.

    Then Iwill think long & hard about ablation for fibrillation.

    So many wrote positively about AF.

    I suspect I have been inAF for a great many years - but was only diagnosed in2010.

    Wastage put onwarfarinbut taken off it when I was found tone in NSR when I went infor cardo version (Oct 2010) but then had a full stroke in Dec. 2010.

    Have since been on warfarin and it has take slot of time to be under a consultant - I went private, initially to see someone about the AF and flutter and now see him regularly - he is an cardiologist /EP - Dr. Barry - Morriston Hospital, Swansea and I think he carries out private work at Spire Hospital, Cardiff.

    So onward & upward.

  • Thanks everyone . I feel better now.

    I'm an active 53 yr old with young kids and I'm looking at this as a way of ( as Rellim says) stopping it now before it progresses.

  • I had ablation under sedation and it was not pleasant and the next two under GA.

    If there is a lifestyle change to get AF under control then I cannot see what it might be as my life is already quite outdoors and full of exercise. Its really good to learn to manage and help your condition but there is just an element in treating conditions these days that seems to put the emphasis back on the patient as though they can actually help what they have. Mine is inherited apparently and linked with an immunity problem. I'm afraid that medical intervention was the answer and as a result of my three ablations and other treatments (plus learning how to manage it myself), I now have a full time quite physical job with a lot of responsibility which I love. There is I think no one way to manage this condition and we should use a range of options.

  • Yes, I had oblation with only sedation, not a general anesthetic. From what I hear every case is different, i have know people who had both methods. The specialists understand all that, & so we must accept their decision. Blessings, J

  • I might be wrong here but you don't need an anaesthetist for sedation which shortens the waiting list. I was sedated for my cryoablation at the JR in Oxford. Don't remember any of the procedure once it started. Woke up 3 hours later in sinus rhythm. Job done!

  • Hi

    I am on the waiting list for a catheter ablation at John Radcliffe for Atrial Flutter. I have an appointment with Dr Matt Ginks in December. Was he your Dr? How long did you have to wait for the procedure? As I have been on the list since early Sept. and my consultation about it is not until mid December I guess it is quite a few months. You sound very positive about it, which is great.

    Hope you don't mind me asking.

    Also, does anyone know why, when I live about 40mins from Bristol and nearly 2 hours from Oxford, I would be referred to the hospital furthest away? (My pessimistic nature is already wondering how I am going to get there for a 9h30 appointment if it is snowing!)

    Thanks everyone.

  • Tim Betts was in charge for my procedure. Also I was given end of January for the ablation in the September before.

  • Mikeymike7 is correct. When I asked my EP why he had decided that I should have a GA he replied " I want an Anaesthetist to look after you so that I can concentrate on your ablation."

    Bear in mind that it takes much longer to recover from a GA. Tiredness is the main problem. I'm told that it takes up to 6 months for your system to be cleared of its effects.

  • My first PVI was undersedation and it was no problem, they gave mesomething to relax and timeflew by. When they started burning it hurt. I remember groaning,immediately hearing the word Morphine, next thing wokeup in bed hours later.

    Sorryabout the typing, usingmy iPad which seems to ignore the space bar half the time 😒

  • Had my catheter ablation under sedation at Queen Alexandra's in Portsmouth. 3 days prior to that they took pictures of the heart with a camera down the throat. Can't remember the name of the procedure but it wasn't too bad - a bit like a bronchoscopy of which I've had two.

    As for the actual ablation, apart from being very nervous at first and quite a severe headache halfway through, most of the time I was nodding off with the sedative - so my fear of being unable to lie still abated. A few odd moments when they stimulated a few things, including the diaphragm I believe - but apart from that it wasn't as bad as I had anticipated. I had a lot of bleeding the following night from one of the entry sites in the groin - but the nurse dealt with that well.

    I'd have it done again if absolutely necessary - but it's worth remember that things probably take longer to heal the older one gets.

  • Thanks kipper.

    I'm only a 53 year old lad so should heal up ok.

  • Many in the medical field, BobD and others on here rightly state AF begets AF and therefore it will get worse over a time period which may be short or may be long. Many also say best to get it done - if it is offered then the EP must think that you need one, you will benefit and are a suitable candidate!!! If one of those combinations was missing they would be offering it to somebody else. Also just look at the statistics - the success of an ablation (regardless as to the number of ablations) for those still in paroxysmal AF (PAF) as opposed to those who are in persistent AF.

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