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What is ablation awake like?

I had an ablation a year ago for afib but I was put to sleep for it. Now I have been having episodes that my doctor says could be flutter or could be AVNRT, along with some afib. This time he wants me to be awake, I guess the better to explore what's going on. What's that like? It has probably been covered before in this forum but I can't find anything.

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Hi Jane and welcome to the forum. When you say your doctor wants you awake this time I guess you mean under sedation? I've had two this way and you are not really aware of what's going on and I certainly didn't feel any pain. A nurse sat watching me all the time and as soon as I started to become aware they would signal for more sedation. I had a third one under a general anaesthetic.

Jean

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Thanks Jean,

I think the idea for this procedure is that he wants to discuss with me as it happens what I am feeling as he attempts to trigger the afib, flutter, AVNRT etc.

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It's like you're aware but not, a strange feeling. I doubt he will be saying much to you as he'll have you linked to equipment that will tell him most of what he needs to know. You can appreciate that he wont want you to move at all. I was aware slightly of all that was going on, but at the same time out of it. I think that's how he'll keep you.

Jean

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Hmm. Last time I was completely sedated. This time he said he wants to communicate with me throughout the procedure, that it will help him define the problem. I assume I will be somewhat sedated. Thanks for your replies!

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Thanks Jean. I don't know why they didn't just put all of you people right out of it like they did with me the first time. In this case the doctor says he wants me awake to get my feedback on the table and I was hoping to hear from someone who had had that experience. I have glimpsed responses relating to that specifically in posts a while back but can't find them.

Jist curious to hear what others who had that experience had to say but no big deal, time will tell!

Thank you all. Everyone in this forum is so nice!

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Just wondering what on earth you could possibly say that would be helpful. My EP apologised to me a few times for the length of the procedure, was 6hrs. I was getting really fed up with lying there for so long and it was cold.

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Agree totally with Jean but be sure to make the team aware if you are experiencing any discomfort. I tried to be a brave little soldier but should have spoken up a bit quicker.....you will be fine!

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I had 2 ablations both under sedation. During the first I was completely out of it for the whole 5 hours although I came to from time to time. During the second I was aware of everything and felt dicomfort and pain. I asked for more sedation and felt it being administered but still had discomfort.

If I ever had another I would want a long and frank conversation with whoever was administering the drugs before agreeing.

Not meaning to be offputting but I feel I have to be honest.

Good luck.

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I was awake for most of my 4 hour ablation and while it was uncomfortable I can't say I was in any great pain, I can remember the EP talking to the other doctor/assistant saying number 6 and 7 needs tidying up, do you want 25 or 35 amps, then hearing a click as the RF ablation starts and then a strange feeling in my chest, I think they didn't quite give me enough sedation but as I said more uncomfortable than painful, at the moment 7 weeks on it has been a great success

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I had an AV node ablation in 2016 " with a pacemaker insertion at the same time. As I was not given general anesthesia it was considered an 'awake' procedure. Actually an anesthesiologist was present for 'standby' and kept me well-medicated throughout. I would open my eyes occasionally but felt no pain, was relaxed and remember nothing of the procedure. It's easy to say don't be nervous but as a retired operating nurse you most likely will also be medicated as it is in the surgeon's best interest to have a relaxed cooperative patient. I hope everything goes as well for you as it did for me. Take care. xx😊 irina

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I would describe how I felt like this: Had 3 to 4 large Guinnesses.

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I think that your consultant should explain exactly what he wants to talk to you about during the procedure. Sounds a bit dodgy to my lay man's ears

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I had one under sedation in June and while I wasn't aware of what was going on most of the time I did become aware of pain at times and could hear myself saying "that too sore" and then I must have been topped up with sedative. I wouldn't hesitate to have it again if I need it in the future. Hope this helps.

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Giorgianjane

What type of ABLATION ?

I have had two ablations recently.

One a cryo PVI in left atria for AF and the second an RF for reentrant flutter in the right atria.

I was mildly sedated for both but I could not really tell - I was not drowsy . I was fully concious through both.

The groin in treated with a local anaesthetic - I had no pain there during the procedures and very little after.

The pain during the cryo is like the brain freeze you get when you bite into a very cold ice cream it lasts a bit longer and is colder but is the same feeling. It happens 4 times once for each pulmonary vein.

I have had worse pain at the dentist.

The RF ablation was a bit more painful but a long way from terrible. The pain I had felt like it was in my right shoulder. It did not go on as long as the cryo for each burst.

On both of my ablations my chest was covered with a scanner which could rotate and move up and down the body. Adjacent to the table i was lying on is a very large screen which had images of the catheters and also multiple wave graphs of the AF. I assumed these were the problem signals as I was ablated they levelled out one by one.

I found it quite interesting although I did not ask any questions as I did not want to distract them from the job!

It is nothing for you to worry about.

If i needed to I would have another ablation tomorrow.

Hope this helps.

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Hi

Well, I had an 'atrial flutter' ablation last July, which has not improved my quality of life and I am now about to have an ablation for 'atrial fibrillation' (in 2 weeks, if it is not cancelled a third time!). The first ablation was only with a local anaesthetic in my groin area for the catheter. The procedure was supposed to be and hour and a half but took 3 hours. I was totally aware throughout, and for me, it was horrid! I felt them moving around in my heart area and had to ask them to stop a couple of times. It was very uncomfortable, and even to this day, when an 'episode' is happening, I feel the sensation I felt when they were doing the procedure! I am very symptomatic with AFib (have the lone paroxysmal type of Atrial Fibrillation) and maybe I am just very sensitive! However, I think you should know how I felt.

The next ablation at the end of June, is at a completely different hospital, different cardiologist and I shall be having a general anaesthetic. I am a bit nervous of that, I have to say but was dreading having to go through an ablation being awake.

I hope it is better for you than it was for me!!! Maybe I am just too sensitive!

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Hi fifitb..I completely agree and had a very similar experience. For me the worst bit was when they used the pacer to set my heart into Afib as I was in SR... I found it so uncomfortable and decided that if there’s a next time I would go for GA as I am also sensitive and have a low pain threshold..They did say I would be sufficiently sedated but I didn’t feel I was and felt pretty much awake through out..Hope your last Ablation went well and you are well and recovered!

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I had an ablation three months for afib and flutter. I was aware for most of the three and a half hours. I need feel a burning sensation in my chest which at times was uncomfortable but bearable. I would have no hesitation in recommending having the ablation done this way. Good luck

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