I’m to new contributer to this forum, apart for answering a couple of question but it has been such fantastic scource of informationt and reassurance to me me over the last two years. My experience of A/F follows a familiar path. at the beginning of 2016I developed an irritating cough and felt I was more aware of my heartbeat than usual. On my G.P’S recommendation (which I felt was a bit of a overreaction at the time) I went to a walk-in E.C.G clinic at my local hospital. Much to my surprise a confusion I was ‘kept in’ for three weeks, diagnosed with A/F and sent home on medication. Then followed a frightening couple of months of returns to the hospital often by ambulance as my heartbeat swung between sinus rhythm and Afib. This forum helped me choose between options I was offered which were, do nothing, medication or ablation. I chose ablation. I found a good electrophysiologist and in Feb 2017 I had the procedure. It worked well until Feb this year when Afib returned. I have a Kardia machine so I was get to get a print out e.c.g when I felt my heart was irregular. This was analysed as A/F and have now been offered another ablation. Again this forum really helped me understand that this was not unusual for it to break through again after the first time, so I have decided to have another ablation. This is where I really need your advise. I was told by a very nice pre admission nurse that the consultant doesn’t think G.A is necessary for this procedure and wants me to use to use sedation. It has also been explained that I will have a wait a longer to get a date, and it also makes it less likely the consultant I want will be available.
I do get where they are coming from and would actually prefer sedation as I’m sure the recovery period is quicker - but when I think of being in any way conscious while someone burns and freezes part of my heart, I become very squeamish and frightened. I’m usually quite tough around this sort thing and I realise I have no idea of what it feels like or indeed if you feel anything! I’ve got to decide this week so I would really appreciate all sedation experiences good and bad. Particularly any one who can compare the two.
Thankyou so much,
Warm regards,
Ruthypegs
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Ruthypegs
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I would have Sedation, because if they touch any thing they shouldnt you can put your hand up and tell, like when they touched my phenic nerve
I’m sure you will get a lot of replies, but here is an old thread. It’s not an easy decision. Very long general anaesthetics may not be good for the elderly brain, and I’ve had 2 under GA, the second of which left me confused for 8 or so hours.
Hi Ruth! I've had 3 ablations, first two with sedation and my third one GA. Don't worry too much about the sedation. You will most probably be away with the fairies most of the time. If you feel pain you can just indicate and they will top the painkiller up.
I felt pretty good ( not to say relieved...) after the sedations but quite dreadful after GA.
I'm on the list for a 4th ablation and would rather hope for sedation but will go with what my EP deems best.( hoping I won't need to have it done at all if I can keep out of A&E for a few more months !!)
Sandra
It's difficult to advise Ruth because we all react differently. My first was a Cryoablation with sedation and although there was some discomfort, it was bearable and the team responded to my requests for more knock out drops! For the second, more recent RF ablation, the same EP decided on a GA and I think that was because it was easier for him because the patient doesn't fight back! The recovery was longer with the GA, more dizziness and nausea and it took a while to leave the system. I suppose 4 months on it's difficult to say which was the easiest to put up with so probably not much help to you but I hope all goes well, whatever method is used....
For me it’s GA all the way. My first ablation was for SVT under sedation. I kept waking up and stirring and wanting to cough. They kept topping up sedation and painkillers but I was beside myself. After 4 hours the EP said he’d have to stop. Apparently it was very easy to trigger my arrhythmia so I went back 6 months later and had it done under GA. Last year I had an AF and AFlutter ablation under a GA. I know many people are fine with sedation but it’s not for me.
I can't really comment as mine was done under GA as my EP would not do it any other way due to another medical condition I have, however I do know that I had to wait at least 6 months longer to get it done as the procedure requires a larger team and the 3 EP's at the hospital have to share this team
Definitely sedation - so much quicker to recover from. I don’t remember much from the ablations I had and was very hazy when I was awake. 20 minutes after returning to the ward I was eating a meal, that wouldn’t have happened with GA. As others have said, some EPs prefer GA because they give you a drug which paralyzes you - Which is why they need to breath for you - which is why I wouldn’t have a GA if I had a choice.
Your post replies show how different we all are. I've had 3 ablations. The first one was with sedation, very long (about 5hrs) and the patient due after me was cancelled. A nurse sat watching me and every time I stirred, increased the sedation. I can't say I felt any pain, but was aware slightly as they did the burning. That was fine, but I felt ill for weeks afterwards. When I went back to the ward I heard one nurse say to another in surprise, look how much (can't remember the name of the drug right now) she's had!
My second ablation was under sedation too and after recovering from that I felt I never wanted to have one one by that method again. It totally traumatised me and I felt I had post traumatic stress afterwards and should have had counselling. Again I felt ill for weeks afterwards.
With my third I was overjoyed to discover I was to have a general anaesthetic. As they did the procedure I knew nothing about it. I felt great that evening and did so from then onward. I was far more alive and perky than with the other two.
As I've said, we all respond differently to procedures and certainly after my first ablation under sedation I didn't hesitate to have a second that way, but I far preferred the GA and couldn't have faced a third carried out in the same way as the first two.
Perhaps your EP knows that it will be a short procedure and that's why sedation has been suggested. Also, I guess sedation is a lot safer than a GA.
I think that I would ask why the EP is suggesting sedation this time especially as he himself may not be doing it. My EP only does ablations with a GA and that includes whilst you are having the TOE. I think it's important to know who will be doing it, their experience, their preferences
I’ve had 2 ablations the first under sedation the second under a GA. I remember a lot about the first and was cardioverted at the end of the procedure. I wasn’t given a choice by my EP the second time around and it was much easier. I was out of hospital the following day in both instances. Actually it was a relief to have the decision on the second ablation taken out of my hands.
What you are having is more complicated than what I had --- but when they put a pacemaker/ICD in me in June they just sedated me. My GP was able to get a copy of all my records for the week I was in the hospital, and it was really interesting. I was given Fentanyl and a 2% Lidocaine shot, and it took about 45 mins to insert the pacemaker/ICD. I was 100% out of it the second they gave me the shot, and never felt a thing. I'm not sure how long the sedation lasted, but I woke up safely tucked in my hospital bed later with no problems at all. I wasn't "high" or weird or anything, and actually just slept most of the time for the next couple days. No side effects that I know of. I know fentanyl is very dangerous and has killed a lot of drug addicts, but getting the right does of the pure stuff in the hospital worked just great.
I had sedation for my cryo, absolutely no problem, will have it for my RF touch up shortly. My wife had sedation for EP study and cryo ablation and thought it was throughly unpleasant, however she will have sedation again for her follow up touch up. Hope that helps!
I have had two ablations for vt. Both times I had sedation but the two were very different experiences. The first time I was given the sedation first and then given the drug that speeds up your heart after for the ep study. I didn't remember anything other than my heart thumping in my chest. The second time was more unpleasant. I had the ep study first and I felt quite strange. I got the shakes and I could not understand why and was afraid to ask. My husband explained it was the adrenaline drug they use. They gave me the sedation at what seemed to me to be the last minute. The saw the screen go up in front of me while I was still fully with it and catheters inserted. I started to come round towards the end of the procedure and feit what I would say was uncomfortable bit not painful sensations. I did not tell anyone I was conscious, I don't know why but I definately had less sedation second time round. I recovered very quickly from both ablations though and was home next morning, no issues at all. Good luck with your choice. Seems like everyone had different experiences.
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