Ablation experience whilst being conscious

[Colutd]

Hi

I have AF and I wondered if anyone could share their experience of having an Ablation whilst not being put under by an anesthetic please

[djbgatekeeper]

Hi there, I had a Cryoablation in September last year whilst awake, I was given some light sedation but maybe because I was nervous I didn't really gain much benefit from it. As mine was a Cryoablation (freezing not burning) I felt the process quite clearly, it was a bit like a bad case of brain freeze when you eat ice cream to fast. I also felt the catheter travelling to its destination which was a bit weird but not that bad. Overall I would say the process was uncomfortable but I've had worse at the dentist so nothing to be really scared about. If you are awake ask the nurse to top up your sedation and hopefully that will do the trick for you.. Best of luck and don't worry as it will be over fairly quick and once you've had the experience you will be much more confident if you ever have to repeat. And of course you will have a great team around you as well... Best of luck and keep calm 👍

[Colutd]

Thank you djb

I am not due one as I have already had an ablation 3 years ago but that was whilst being under

I am no longer under private medical cover and I’m told if you have an ablation on nhs it has to be whilst being conscious?

So I was considering having private insurance again in case I have to have another one at sometime but it’s so expensive to have the medical cover now

[djbgatekeeper in reply to Colutd]

I would say you have been told incorrectly, I was planned to have a GA on the NHS and the night before my procedure I was phoned by the hospital to ask if would be ok to have sedation instead and I said yes. You might find the wait is longer for GA as of course it involves more staff but the NHS do provide that service. Maybe ask your GP or hospital to check as the GA might be area specific?

[pottypete1 in reply to Colutd]

It is a very individual thing.

I have had 3 ablations under sedation followed by 4 under GA all on the NHS.

Personally I would never accept sedation should a need for a further ablation arise.

I found the experience under sedation horrible, guess I am not made the same way as those who describe it as “a walk in the park.

Pete

[Kaz747 in reply to pottypete1]

I’m with you Pete. I’ve had one ablation (for SVT) under sedation and two under general anaesthetic. I’d definitely want to be knocked out. The first ablation was horrid and in the end the GP called it quits after 4 hours because even with sedation and pain relief I wasn’t coping or able to stay still enough.

[10gingercats]

The rest of my e mail disappeared! A hole in the heart closure was much the same,I guess, as an ablation in terms of groin entry and 'fumbling' about around the heart to fix a gadget to close a bothersome hole. I had a light sedation and a squeak from me at one point soon brought on the morphine!They do not like wrigglers.

[sportscoach]

Most NHS hospitals are strapped for cash so use sedation because it’s cheaper than a GA.

My neighbour is an anaesthetist who explained although small, there can be complications with a GA and in a lot of cases it can leave people feeling out of sorts for a few weeks whereas sedation you can be up and about in hours and carries less risk.

I took the sedation route, can’t say it was a problem I felt a little burning in my chest but just mentioned it during the procedure and they just gave me more medication, I recovered within a couple of hours and didn’t have the hangover from hell without the pleasure I knew I would have with a GA

[lms0006]

I have had 3 ablations and was always put under would not do it any other way

[jedimasterlincoln]

People's ablation experiences are different, no two are the same - it's important to note that.

For me personally, I've had 4. 2 were PVI ablations on the left, 2 were flutter ablations on the right. I have had complete faith in my EP in every instance.

I have never had a GA, planned anyway, though I was intubated and supported by an anaesthetist during/after the first procedure because I had a Vaso-Vagal

(Vasovagal syncope (vay-zoh-VAY-gul SING-kuh-pee) occurs when you faint because your body overreacts to certain triggers, such as the sight of blood or extreme emotional distress. It may also be called neurocardiogenic syncope. The vasovagal syncope trigger causes your heart rate and blood pressure to drop suddenly) whilst on the table. I only really remember the tube coming out in recovery and being told to cough.

Under sedation, for me personally I should stress, I've been relaxed on doses of fentanyl and midazolam (on a couple of occasions the nurses have helpfully told me if they'd had the level's I'd had in the lab they'd be dead or it was enough to take down a horse) and been awake and aware.

What I found frustrating about the Vaso-Vagal was I was finding it all very interesting looking over to the left and seeing the telemetry.

Apart from that, I've been awake and aware, though I'm sure I've also drifted off to sleep a couple of times.

I won't lie, for me personally, I find them very uncomfortable borderline painful but they are wary not to give me too much sedation. The very first thing the EP said during abalation number 1 was "It will be uncomfortable but let me know if it's painful" and I always do, sometimes he agrees to more sedation sometimes he doesn't. The crushing/burning/stabbing pains in the chest are bad for me - and they are slightly more prolonged than the initial onset of a PAF episode.

I should say again that this is just me, and all my 4 experiences have been similar, that is not to say someone else with a different heart/older heart/unscarred heart will have the same experience.

[Groover8391]

Not a problem at at all. The theatre was cold but they asked me what music I liked and they played Oscar Peterson. NHS hospital in the UK. Don't worry about it.

[kakapo]

I have had one ablation with both cryo- and radiofrequency ablation under sedation. It went really well but I remember absolutely nothing and had the same experience when getting two stents .So for me it was no hassle at all but I would do it without any sedation if I had to to get rid of AF.

[Romboy]

Hi, I’ve had 2 PVIs under GA and a full EP study under sedation. The study would have been an ablation if the AF had lasted long enough to map. Recovery from sedation (fentanyl) was much easier than GA but if it was a left side of heart (like a PVI) I think it’s best to be out so that you definitely don’t move at the wrong point! Wasn’t painful although I think I was well dosed on the opiates!

All NHS and all clinical decisions rather than financial.

[Hidden]

Hi

I’m 18 and I have had 4 previous ablations 2 under general and 2 local with no sedation so it all depends on you at the end of the day, I didn’t choose to have general it was needed as both those procedures took 6-7 hours ( far to long to be awake ) the ones when I was awake, uncomfortable putting catheters in groin but not painful, the actual burning is not very nice at all but isn’t in for very long so just grit your teeth and before you know it it’s over ! Hope this helps

[Hannas]

Hello, I had an ablation a year ago and all I can say is you’ll be fine 😊

The experience is somewhat different yet AMA I g at the same time as you get to see it all on the screens.

I found the most painful part was when they pulled out the catheters in the groin.

Good luck

[KMRobbo]

I have experience of two ablations , one cryo PVI for afib, and one RF right atria for flutter . Both under mild sedation.

The cryo exaclty as described by djbgatekeeper : the pain is the brain freeze from four big bites of a cold ice cream ( one for each vein), not an issue. No pain in the chest. I could see the big vdu screen with the mapping and also the waves from the heart I found it very interesting. ( I never asked any questions though , didn't want to distract anyone!)

The RF flutter was a bit more painful but shorter, the pain for that was up near the right shoulder. However it was not major and it was shorter.

I agree I have had worse pain at the dentist

The groin entry was no issue at all either time. Local anaesthetic and I felt nothing, don't recall even feeling the needle. My ablations were only 4 weeks apart but groin enntry still in the same place. No problem afterwards. I was 57 when they occurred ( a year ago).

I never considered GA as it was not offered but. Thinking about it I would sooner have the sedati . The few times in my life I have had a GA I woke up feeling really sh*t and disorietated . After the ablation s both times I felt pretty good particularly the last as I was aware that flutter that I had for 3.5 weeks had stopped.

[Wasp1954]

Had my ablation (Radio frequency) 3 weeks ago this Friday in the QE Birmingham. My biggest fear was the initial groin entry - don’t even remember it! Up until the actual burning it was a breeze but I found the actual ‘burning’ uncomfortable/painful. I was told to keep still and was given more fentanyl. Out just under 4 hours. Post procedure I was a bit sore especially deep breathing but that soon went. Groin was tender, still is a bit but all in all it was no worse than visiting the dentist. Gotta take it easy afterwards and my body has certainly told me to!

[dmac4646]

You should be aware that at least one respected EP has said results are better with a general anaesthetic mainly down to the fact you dont move.

[pottypete1 in reply to dmac4646]

Yes I read a very complex report on a study some time ago.

Pete

[dedeottie]

I have had 2 both with sedation both with the same team. The first was fine. I dont remember much as I was so sedated. The second was not pleasant despite me asking for more sedation/ painkillers. I have no idea why it was so different except that the whole experience was bad in the second culminating in an unpleasant complication. X

[Hidden]

It is safer under sedation (I was told this when I had upper wisdom teeth removed). A GA will slow everything down, breathing etc., and this requires very careful monitoring. It has also been widely reported that there is an association between GA and dementia ( this does *not* , of course, mean that everyone or even most people who have a GA wind up with dementia). So basically, there is a trade off between safety and comfort. I have an assessment for an ablation at the end of January and so will be discussing this matter with the EP. I don’t whether I will be offered an ablation, or what, if I am given the choice as between sedation and a GA, I will opt for. I must admit to being a bit put off by the experiences of some here under sedation. I had a fairly minor hospital procedure a few years ago and, after being told I “probably wouldn’t remember anything afterwards”, found that the sedation had absolutely no effect whatsoever. I conversed with the staff throughout, remember every detail of the conversation and read a technical book on economics on being taken back to the ward.

[Samazeuilh2 in reply to Hidden]

The dementia topic is a complex one. I had some concerns about this prior to a a four hour procedure recently. Anaesthetists were rather vague about the topic, professing ignorance. That said, this article suggests the relationship *might* not be as clear cut as is often supposed.

alzheimers.org.uk/about-dem...

[PengieP]

I woke up during a catheter ablation for atrial flutter. I was not supposed to wake up. SO when I opened my eyes, I heard the medical staff loudly say DON'T MOVE! So of course I didn't. They asked me if it hurt. And it did, but well below my pain threshold. And in fact it was informative since I got to feel what heart pain felt like a bit without being in danger. So it was a good thing. None the less when they asked me if I felt pain, I said "Yes, but it's not bad and I'm fine". It felt like a sharp painful buzzing in my chest just left of my centerline and about 2 inches below a line drawn horizontally between my clavicles. They replied, "We're going to give you something", I said "That's ok, it's not too bad" and it really wasn't and I was curious to be sure I knew what heart pain felt like . But they knocked me the hell out. And my recovery from whatever anesthesia they gave me was by far the worst part of the process. IF you wake up the pain won't be that bad. Especially if you keep in mind they are destroying problematic tissue.

[Samazeuilh2]

I haven’t had an ablation, but I had an angiogram which isn’t hugely different. The sedation was effective. Diazepam was administered via a canula. It’s difficult to describe the sensation but it felt relaxing and made everything interesting. So I looked at the screen and thought “isn’t that fascinating -it’s very advanced technology”. Then when they inserted the canula I thought “oh, yes that’s just like I saw on YouTube, how interesting.” Basically the time flies and you feel rather sleepy for a few hours afterwards. I had a bad result from the angiogram-I needed a bypass. But this didn’t sink in until hours afterwards. So I’d say you’d be ok with just sedation.

[Colutd in reply to Samazeuilh2]

many thanks for taking the time to reply and telling me about your experience. Much appreciated.

I’m sure you’ll be fine with the by pass and I wish you all the very best.

Danny