General or local?: My EP has decided... - Atrial Fibrillati...

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General or local?

Maura5 profile image
38 Replies

My EP has decided that my Ablation that I had back in July has failed...... no surprises there!

So, I have been asked if I would consider having the next one with local anaesthetic and light sedation as the waiting list would be shorter. I had two ablations many years ago for SVT which were much shorter than the last one I had for AF and I had no sedation, it was awful but necessary for that procedure. So my question is to those of you who have had an ablation for AF with a local anaesthetic, how was it for you? Or if you’ve had it done both ways, which one was better for you?

Sorry for the long post and thank you as always for your valuable help.

Maura

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Maura5 profile image
Maura5
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38 Replies

I've had 2 with sedation each lasting -/+ 4hrs and last one GA. Pros and cons for each. Much quicker recovery for sedation which is not really that bad as they can always up the painkillers if you indicate and most of the time you feel like you're in LaLa land anyway..... At least that's how it was for me.

I'm on the list for no 4 and I'll take which ever is offered.

Sandra

Maura5 profile image
Maura5 in reply to

Thank you for your quick reply, my thinking is that I will probably go for whichever one can be done quicker! Nice to hear your experience wasn’t too bad.

in reply toMaura5

I always find the worst part is lying like a slab of meat on a very narrow bed in a freezing cold lab with strange people putting electrodes all over my body 😯😕☹........

dedeottie profile image
dedeottie

I have had 2 ablations, both under sedation and both with the same team. The first took 5 hours and I didnt feel a thing. I was out of it for almost the whole procedure. The second took less time but I was very aware throughout and felt discomfort and sometimes pain. I did request more pain relief and could feel myself relaxing as it was administered but unfortunately it seemed to have very little lasting effect. I've no idea why this should be the case. X

Hi Maura, I have had both. The first, a cryoablation was carried out under sedation which is not unusual and was OK, but I did experience some discomfort during pacing and also some fairly rigorous shivering but I probably should have asked for more sedation. The second RF ablation was under a GA which was easier because I literally remember nothing. The other advantage is that I was perfectly still which makes mapping and manoeuvring the catheters easier and safer. The early stages of recovery from the GA was not pleasant but I don’t recall any longer term problems.

I guess if I had to go for a third, I’d opt for a GA but it all depends on how your system reacts to recovering from a GA.....

Maura5 profile image
Maura5 in reply to

Thanks flapjack, that’s very helpful advice

MarkS profile image
MarkS

General anaesthesia can have long term effects on cognitive function. I would avoid it if it's not strictly necessary, and is worth a little bit of discomfort.

Bagrat profile image
Bagrat

Never heard that after 40 years nursing ,have you a citation I could read?

CDreamer profile image
CDreamer in reply toBagrat

healthline.com/health-news/...

There are a number of studies showing this - look in the British Neurololgical published papers.

Also GA will exacerbate many other conditions, it will cause inflammation, risks of intubation - I had esophagus spasms which caused a great deal of discomfort for months after the last GA I had. I could go on and on. I certainly also noticed memory difficulties and difficulty in making decisions - even silly every day ones such as which coat to wear.

Bagrat profile image
Bagrat in reply toCDreamer

Thanks CDreamer it is 15 years since I retired! But that is no excuse. Will have a read. I'm aware of other effects and interactions and I was worried when OH with perm AF and very mild cognitive decline had GA in case it exacerbated that ( doesn't seem to have been an issue) but thought that was me being anxious.

CDreamer profile image
CDreamer in reply toBagrat

I think some people are just much more susceptible to affects of GA and I know I am so I will avoid if I possibly can! I think the astonishing thing is that doctors really still have no idea of how GA works to make us unconscious.

Bagrat profile image
Bagrat in reply toCDreamer

Indeed that is a bit scary!!

CDreamer profile image
CDreamer

I had 2 and they were great, I drifted in and out of sleep and had no pain.

I just had PM implanted with only a local and pain meds and again absolutely fine.

The affects of a GA are greater and risks higher. It takes me months to recover from a GA so light sedation for me anytime! Sedation recovery time is so much quicker, I was eating my dinner 15 minutes after my ablation, no way would that have been possible after GA.

in reply toCDreamer

That's interesting CD.....i must say I felt absolutely awful when I came round from my GA and some time afterwards. Thought this was normal. Very different to my 2 sedation. Will see if I am given a choice next time.

Patsy10 profile image
Patsy10

Hi,

I have just joined and this is my first post...…….

In the past I have had three ablations and possibly may need a fourth! All were carried out under local anaesthetic in Birmingham. When going into theatre and being surrounded by all the various staff, I requested that I be kept under enough not to be aware of what was going on. I came around just once during a procedure, the consultant shouting stop as I was kicking him in the face! They soon put me out again!

I can honestly say that I had no bad reaction whatsoever to either of the procedures and

requested a sandwich and drink as soon as I awoke.

The best of luck.

Jlaine profile image
Jlaine in reply toPatsy10

This is probably why my ep just automaticlly did GA on me. Less problems for them with no interferance from patient!

Maril1 profile image
Maril1

I had an ablation back in 2008 for Aflutter lasted about a hour awake throughout and went home same day. 2010 ablation for afib pulmonary vein isolation lasting 5hrs . I remember it being rather boring having to lay still . I could see the catheter inside me on one of the big screens and the theatre was quite impressive like something off the starship enterprise as the doctors talked about whether the free sandwiches they had at a conference were M&S the day before. I t was all very professional even the nurses who supplied the banter to keep you calm , though I was told off for laughing as you have to keep still . I did ask at one stage could they put the match on one of the big screens. Towards the end I could feel the burning and was going to put up with it when a doctor asked one of the monitors did he burn some part and I replied no as I could not feel it. He can feel it ! said a doctor I was told off again and given more morphine.Had to stay in overnight as it was a long one.

fairgo45 profile image
fairgo45

Personally I have had 3 ablation under light sedation

The first one no problem

The second I felt a lot of pain

The 3rd one traumatised me it was very long and I felt everything

No 4th one for me

dedeottie profile image
dedeottie in reply tofairgo45

Similar for me but isnt it strange that this should be? I am intreagued! Mine was done with the same team and I told them to give me plenty of sedation both times both before and during the procedure. The only difference was that I had ages to prepare for the first with the help of hypnosis , meditation etc but was called in on a cancellation for second and so no time to prepare. I was definitely more worked up for the second and maybe the adrenaline blocked the effects of the drugs. If anyone has any thoughts on this it would be interesting.

Mike11 profile image
Mike11

I had sedation and it was far better than GA as I could see everything going on and also could feed back to the EP when he asked me things.

Maura5 profile image
Maura5

Thanks everyone for all your replies, it’s good to hear about other people’s experiences. I think I’m going to go for sedation, it did take me a while to get over the GA last time and they say it’s a shorter waiting list for sedation......

Maura

Alfieros profile image
Alfieros

Im having my ablation this coming Wednesday and was told i would be under general anesthesia and that it should take about 4 hours. I’ve been under GA many times and other than a day or 2 of tiredness, I’ve been fine.

MS444 profile image
MS444

There seem to be a lot of (non medical) opinions here regarding GA versus sedation that are potentially misleading.

in reply toMS444

Hi MS444

In what way misleading? My take on this thread is that folk were describing their own experience.

Maura5 profile image
Maura5 in reply to

Yes I agree oyster, I just wanted to hear about people’s experiences, don’t think it’s misleading at all

MS444 profile image
MS444 in reply to

Misleading based on opinions about the safety of general anaesthetics being a justification for using sedation is one example. Best to seek advice from medical practitioners.... Regards

cjsabc profile image
cjsabc

Zero sedation for mine for very sound reasons to my layman's ears. Painful? Yes, but well worth it. That was October 2013 and still AOK.

Maura5 profile image
Maura5 in reply tocjsabc

I had no sedation for my first two ablations for SVT in 2002/3 but both were relatively short procedures compared to the one I had in July for AF which took over 4 hours.

Brizzy50000 profile image
Brizzy50000

Had mine done under sedation in May, uncomfortable yes, painful not really, very long procedure for me 4.5 hours can't remember the end bit either fell asleep or they knock me out, woke up on the way back to the ward.

So far so good.

Maura5 profile image
Maura5 in reply toBrizzy50000

Great to hear, thanks!

Keep up the good work 👍

KMRobbo profile image
KMRobbo

It's not local except for the groin entrance area. You will be in sedation into your blood stream so your body is sedated but you are not unconscious. I Lhave had two ablationS on this basis. If you are in pain you can ask to increase the sedation. I did not cos there was little pain. In my humble opinion you are better off awake so you see what is going on.its quote interesting. I had little pain, had worse at the dentist. Plus GA makes you feel sh*t when you first wake up!

Maura5 profile image
Maura5 in reply toKMRobbo

Yes it absolutely does! Thanks for your reply

Mike-tyson profile image
Mike-tyson

I had mine done under a local almost two year ago at UHNM in Stoke. I was in at 8am and on my way home by 3pm. Was a little uncomfortable when Ablation being done but no big problem. And much better to get home the same day.

Maura5 profile image
Maura5 in reply toMike-tyson

That’s good to hear thanks, how long did your procedure take?

Hilaryjm profile image
Hilaryjm

I recently had a second ablation at Papworth. Both were done using local anaesthesia and conscious sedation. Fine both times. I was aware of some discomfort some of the time, it it was not a problem, and I went home later the same day. Would recommend this approach, provided you have support at home, and can rest.

Maura5 profile image
Maura5 in reply toHilaryjm

Thanks for your good advice, I have decided to go down the sedation route, I do thankfully have support at home.

Petrified profile image
Petrified

I'm opting for GA - absolute coward & EP tackling AF & atrial flutter, so it could be quite a protracted procedure. He said that it makes absolutely no difference to him if it's sedation or GA. Of course there are risks. I've found this site very helpful and reassuring in helping me cope with the AF. There's advice and support here that I've not found anywhere else. Inevitably some people have unfortunate experiences and wish to make others aware of what can go wrong or has gone wrong. I'm travelling hopefully!!!! Downside of GA is that the waiting list is longer. Good luck with whatever you decide is best for you. Hope all goes well.

Maura5 profile image
Maura5 in reply toPetrified

Thank you! I’ve decided I’ll go for sedation just to get it done faster hopefully. I’m in the middle of an episode now that’s been going for a few hours, it’s so debilitating, everyone is affected differently but I’m fed up with this now

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