Unexpected complication after ablation

[Waverly1]

[ content warning -- unpleasant clinical details -- ] Posting about my husband, 57 years old, AF for a month last December with high heart rate, put on the antiarrhythmic Dofetilide (we are in USA). A month ago he had an ablation, it took 5 1/2 hours, they ended up having to do both cryo and RF so he had two groin wounds. All was well except for complications with his urinary catheter. He had general anesthesia and was in the hospital overnight. (planned). On the evening after his surgery they took out the urinary catheter and it was bloody, and he peed bloody urine, but it got better the next day and he was released. But he was not able to pee well over the weekend, and by Monday we took him to emergency, and turns out he had to wear a urinary catheter for a week until he could see a urologist, and after that, all turned out to be well. We were prepared to worry about his heart and his groin wounds but this was completely unexpected! Just was wondering if anyone else has gone through this! Love this site and everyone's support by the way. He's feeling great now, back to biking to work! (well, the ferry helps him along the way).

[sweetiepye]

I'm happy everything turned out well in the end. Complications can occur with any hospital procedure so there is always a risk. I'm interested in the use of cyro along with RF. I haven't heard of this before. Were you surprised by that ? Your husband's lucky to have your help. I wish I had a wife when I go through these things. Pam

[Waverly1 in reply to sweetiepye]

Yes we (well I) were surprised! It was scheduled as cryo, and then after about 4 hours into the procedure they notified me that there was one area that they couldn't get to with cryo, and they were going ahead with RF. On Nov 25 we will see the EP and maybe we will get more details. My husband is very laissez-faire with all this, I'm the one who's all freaking out and asking questions and researching ad nauseam! So, I guess we make a good team.

[CDreamer in reply to Waverly1]

It is quite normal to have RF after Cryo - but often in UK not at the same time. Many people have physiology which just doesn’t match the equipment so they need to ‘fill in’ the areas not reached by the balloon and that takes much longer so is why it took 5 hours. I have 2 co-joined pulmonary veins which meant I could only have RF and therefor took 7+ hours but I also didn’t have GA so recovery was much quicker.

Sound like a minor blip due to the catheter insertion - hope the recovery goes well and the procedure successful.

I think it is much harder watching our loved ones going through stuff than ourselves - I found supporting my husband through angiograms, investigations and cardioversion and helping him make up his mind on treatments much, much more stressful than for myself.

[sweetiepye in reply to Waverly1]

Yes, I understand that. I have the afib , my husband is the freak. oops! Seriously, when you're the one with it you have to distance it a little because it is always lurking.

[Hidden]

As I expect you know, it’s not unusual for the expanding balloon used in a Cryoablation to miss tissue in the pulmonary veins due to some veins being irregular in shape. Generally, if this happens here in the UK, a second RF ablation is carried out at a later date. Apart from the unpleasant experience, it sounds better having it all done at once and hopefully your husband will soon be fully recovered.

Under the circumstances, it sounds as if he might be doing too much too quick. You say he had the ablation(s) 4 weeks ago and 3 weeks ago he had a urinary catheter removed?

I suggest he reads the factsheet on recovering from an ablation, link below......please bear in mind, this factsheet was written by folks who have experienced having an ablation. EP’s are obviously experts in their field but not many have actually had one and most first see their patients 6 months after the event by which time (fortunately) memories of the early days have faded. Sometimes, they can be a bit optimistic about recovery.

heartrhythmalliance.org/res...

[BobD Volunteer]

I never needed a urinary catheter for ablation although had several during prostate cancer surgery and recovery. At two weeks post surgery the catheter was removed ( prostate cancer usually results in incontinence ) and I was unable to pee other than leakage so a second catheter was fitted for an additional two weeks after a camera had been used to check no damage. At about six months blood was noticed and a second camera showed no damage other than capilliary inflamation due to radiotherapy. Since then (eight years) no issues.

I would suggest that some investigation (camera ?) would be a good idea to confirm that there is no inflamation of the water works which may be lurking or developing. Ignorance is not always bliss.

[Waverly1]

Thanks BobD for the advice on the camera, we will ask the urologist. That's quite a bit you went through, I'm glad that's in the past for you. The home catheter thing, while certainly no picnic, was not as bad as some people might think, so that was interesting to find out. FlapJack, yes, my husband did read the fact sheet, and yes I agree, I think he's pushing it a bit. On the first day on the bike, he admitted to being overly tired after coming up our final hill, so I've been picking him at the bottom of the hill.

Getting ready for a two-day mandatory power outage here in California, fun times!

[estrennen]

Agree with a "10" during catheter removal. That was the worst part of my ablation procedure, 4 weeks ago so it's fresh in my mind. I also had bleeding for a day after the catheter removal. In the future I will ask that they remove the catheter at the end of surgery.

[barbly1]

They don't use a catheter during the ablations at Texas Cardiac Arrhythmia, instead using a collagen plug for the groin wound, which doesn't require resting for a long time post-surgery. You are able to get up to pee pretty quickly. Also, no bruising at the wound site with the collagen plug.

[Waverly1 in reply to barbly1]

That’s really interesting, about the collagen plug. Will have to ask about that if there’s a next time.