General anaesthetic or sedation for ablation?

Does anyone know what the criteria are for this decision?

[beardy_chris]

Mostly what the EP prefers. Some prefer GA, others sedation. There are some other criteria too - but are usually indicative and not mandatory. Some EPs will be amenable to patient preference.

[sue13hils]

Hi I had GA it was the best for me as I can not swallow camera they do before procedure did try it but could not. And I was so nervous so good luck.

[Hidden in reply to sue13hils]

Swallow a CAMERA! How large is the camera? Don’t like the sound of this at all.

[sue13hils in reply to Hidden]

Sorry if I alarmed you as the others said it's just checking heart for any clots. I have a gagging problem so for me much better to not know what's going on.

[Barb1]

EP preference if private. Cost if BHS.

[BobD Volunteer]

My EP always told me he prefers to have somebody else looking after his patients whilst he works so always used GA. Since sedation does not require an anaesthetist to be present scheduling can be easier and of course there is a cost implication. It is really individual to hospitals/consultants. I know for example the Prof Schilling usually uses sedation as his cryo procedures are much faster and patient recovery is therefore quicker. Fast in fast out.

[jennydog]

My EP said he wanted an anaethetist to look after me while he concentrated on the ablation, hence GA?

[CDreamer]

Sedation for both mine, don’t remember anything so don’t worry about the swallowing a camera - (TOE is to give you an echocardiogram to ensure there are no clots in your heart or nasty surprises before they enter your heart) as the drugs they give mean you will be out of it anyway. I drifted in and out of sleep but it was a long time on the table - 7+ hours - but it felt like 30 mins. I was eating my dinner 20 minutes after getting to the ward. GA takes a lot, lot longer to recover from.

I had an anaesthetist who ensured I was not aware or in pain and I could be converted to GA if required but that I know doesn’t always happen.

If you want to know what happens then there are plenty of videos on line

[Hidden]

I had my ablation under GA last week in QE Birmingham, the EP wanted to do it that way due to my sleep apnoea to give him control over me breathing

[Gowers in reply to Hidden]

the cardio team at QE are excellent - (had angiogram + reveal device fitted) they some very good cardiologists

[Hidden in reply to Gowers]

Supposed to be Mr Lancioni but he got tied up on an op and Mr Marshall slipped me into his list. All seems good after a week.

By the way I was well impressed with the QE, great hospital and staff. Procedures like this aren’t carried out in Herefordshire so their EP holds a clinic every 6 weeks in Hereford.

[pottypete1]

I have had both sedation and GA. The waiting list is longer as they have to have an anaesthetist in the team.

Obviously it depends on the hospital ‘s resources as to what difference this makes.

Personally I prefer GA as I felt that there was more control over my care. The recovery period is longer.

Talk to your EP.

Pete

[Maura5]

I had my first one in July with GA. I need a second one and was told if I opted for sedation this time the waiting list would be shorter than the expected 6-8 months for GA so I agreed. However, I’ve just got my date for next ablation, January 14th AND It will be under GA. I’m surprised I didn’t have to wait long at all and secretly pleased it’s GA!

[Brizzy5000]

I had ablation for Atrial Flutter and AF in May, I was awake throughout the procedure except near the end, either fell asleep or they upped the meds, never had a camera down the throat so I think that depends on the EP.

While not the most pleasant experience under sedation it was ok and would definitely have it repeated if AF comes back.

[indy64]

The only time(s) I've had to swallow a camera was prior to cardioversion. The procedure is called a transesophageal echocardiogram to view your heart for possible clots before they convert so you don't send the clots elsewhere.

My first ablation was 9 hours under GA.

[Hidden]

My experience of GA for ablation has been mixed. The first time after a 5 hour GA I had no side effects and recovered immediately.

4 years later (2018) I had a 4 hour GA. When I came round I was apparently confused and talking nonsense. They gave me 300 mgs of aspirin and sent me for a CT head scan. I found out later that they felt my confusion was most likely due to the anaesthetic, but who knows.

My experience of this episode was that I was trying to talk to a group of nurses standing at the end of the bed. I could hear them but they appeared not to hear me and I could not hear my own voice. My own assessment is that I was briefly aphasic due to a TIA.

I have learned here that repeated general anaesthesia is linked with an increased incidence of dementia.

If there was a question of repeat ablation, I would not agree to another GA, which I believe is not necessary for ablation. The problem is some patients ablated under sedation with pain relief seem to be poorly managed, presumably because an anaesthetist is not present and the EP has more pressing concerns, or the patient is unable to convey whether the anaesthesia is sufficient.

I am 70 years old.

[pottypete1 in reply to Hidden]

Yes early sedation I had was fine.

On the third occasion throughout the 6 hours I was wide awake and I really had a bad experience.

Subsequently I had 4 ablations under GA and the only real issue I had was urine retention.

Hopefully I won’t have to have any more ablations.

Pete

[Hidden in reply to Hidden]

Interesting oyster. I've had 2 ablations under sedation and last one GA which took some getting over. I've no 4 coming up and don't know yet whether I have a choice. Feel I should opt for sedation but will wait and see

[KMRobbo]

two ablations under mild sedation - no problem with either. minimal pain (expected more). The PVI cryo ablation I had is just like biting into a very cold ice cream - just bad brain freeze, not much feeling in the chest, although right at the end I felt like i had swallowed something and it got stuck. A glass of water after the procedure reduced that. Possibly a bit of reflux??. Groin was a local - never felt anything during or after.

If there is a next time I would still opt for cryo - i liked seeing what was going on!

[lovetogarden]

Interesting to read about everyone’s experiences. I’ve had 2 ablations, both GA. Apparently I don’t come around nicely. 😀 both times I remember coming to and having the staff knock me out again. Coming out of the secondary sedative was smoother both times. Unfortunately diig the 2nd ablation, the breathing tube damaged my vocal cords, resulting in yet another surgery 6 months later, ironically p, under GA! That was a quick procedure and I came around easily. So if dementia and GA go together, I guess I’m primed! 😂