Can I have Surgery under a general anesthetic while in AF

[Oscal]

Hieryone ,I have posted here before and got some helpful feedback .A little background info I am a 76 yr male,live alone.I have had PAF since 2012.I followed the usual route with meds.At first dabigatran,bisoprolol,BP meds which I had been on for some years .This worked quite well for years ,but gradually the AF bouts increased in both frequency and length.As I learned from this site ,AF begets AF. Next came Flecanide as a PIP.Again worked well for a time .Eventually had a cryoablation last Dec.This has not worked out and am now getting AF bouts 3/4 times a week ,lasting from 4 to 9hours.My EP suggested I take Flec twice a day ,but I cant tolerate it,as my blood pressure plummets and heart rate to the extent that I have almost passed out a few times.I may be offered a 2nd ablation,I dont really want it but feel I am running out of options.Here is the crunch,I need a few regular operations,Prostate,Hernia,cateract,They have all been put on hold pending the out come of my AF,Due to reluctance to operate on someone in AF.Has anyone else had this problem?I live in London and its NHS.

[pottypete1]

I have had a number of unrelated operations but the doctors favoured doing the operation at a hospital that has a cardiac unit.

Pete

[Buffafly in reply to pottypete1]

I was told I could only have a hip operation in a hospital with a cardiac unit and an ITU bed available. Obvs out of the question now.

[BobD Volunteer]

It really depends on both surgeon and anaesthetist if they are prepared to go ahead. Ten years ago when faced with a radical prostatectomy I was lucky in that I had an ablation a few years previously which had terminated my AF but the surgeon did tell me he would not have wanted to operate had I still AF as it was a 4. 5 hour operation.

[Desanthony]

Hernia and cataract can be done with local anaesthetic and sedation. My wife had both her cataracts done with just local anaesthetic and no sedation. I have had two hernia ops done with just local anaesthetic too.

What prostate operation are you having? I had a TURP to shave area of the prostate causing problems - constricting urethra, using laser back in 2004 before I developed AF and then later had Radiotherapy and Hormone Therapy for prostate cancer in 2016/17 but was not in AF for any of those operations.

I had a total knee replacement last October and was lucky to get a Cardioversion about 2 months prior to it as I had gone into AF after 11 months free thanks to my first cardioversion. Again I had this under local - Epidural and sedation and had no problems. The hospital were in no way worried about my AF so long as you remember to tell everyone - and I mean everyone looking after you that you have it. I had to come off my anticoagulants for 36 hours before the operation and went back onto lower dose for I think 2 weeks afterwards - it could have been a week. I did have more bruising and swelling which lasted far longer than it did for other people in at the same time as me but that was all. The hospital made sure they had a cardiologist on call for the first 24 hours during and after my op.

[Ianc2 in reply to Desanthony]

Agree. I had a cataract done recently, just before the lockdown using a local. I also had a hernia op using a local. Slightly strange feeling to have someone rummaging around in your abdomen.

[Oscal in reply to Desanthony]

Thanks to everyone who responded,however yours is closest to my situation.Im waiting for a TURP .I go to the bathroom every 2 hours at night which in itself is often the cause of my AF starting in middle of the night,or at dawn.Interestingly,in each case of my potential prodedures ,it is the hospital" holding back"awaiting the results of my ablation,which as I mentioned (and have told them) was not a success,or should I say.a complete success.I have been told that Moorfields eye Hospital,does not have a Cardio unit and have often had to "blue light" patients across London who had developed serious problems,during a basic cataract problem.That might explain my situation.As in Bobs case,it is the Anaesthetist who making the decisions.

[Desanthony in reply to Oscal]

I know the feeling getting up so often in the night. Despite everything I still get up 3 times sometimes more. Doesn't seem to make any difference whether I drink a lot or a little, what I drink or when sometimes I can sleep through when I have been naughty and had alcohol relatively late at night and other days when I have been really good and not drunk anything after 6pm I can be up 4 times! I don't know how you can get past these problems with the anaesthesia unless you try and get all the ops done in a hospital with a cardiac unit - which may mean that you wait longer than normal. Maybe the best thing to do is to talk to your Cardiologist/EP and get them to suggest something.

Good Luck,

Des

[Oscal in reply to Desanthony]

Thanks for your feedback and useful suggestion.I now have a bit of a game plan and will try to organise the 3 procedures in the same hospital,if the powers that be are agreeable.My priority is to try and sort my AF,Im hoping to hear from my EP soon and be offered a 2nd ablation.Again,I have learned from this great site,and generous contributers,including your good self,that a 2nd ablation sometimes works. One things for sure,growing old is not for Wimps!

[Desanthony in reply to Oscal]

No this growing old stuff stinks! As I have said before you get medication for one thing which causes side effects and then medication for those side effects. Then you can't remember which tablets are for what pr which consultant does what! It only gets better you know I am 77 tomorrow so feel I am doing OK at the moment. Certainly better than a lot of my friends who are not here they would love to be here wondering if they should have an ablation or which medication is which.

[BRHow]

Most Docs won’t do a case on you if you are on a blood thinner. If you are in constant AF I doubt they want to be the ones to tell you to get off your Blood Thinner., causing you to have a stroke. They will need you to check with your Cardiac doc.

[Thomas45 in reply to BRHow]

As you'll see below I was taken off my anticoagulant prior to an operation to remove my appendix. I didn't go back to taking an anticoagulant until four days after the operation.

[Morg4]

I have had two hip operations under a general. Surgeon was happy but he wanted me to go ITU as a precaution after operation. All was well with no problem

[Thomas45]

I have persistent AF, permanent really as in my 6th year without reverting to normal sinus rhythm. I had an emergency operation to remove my appendix three years ago. I was 72 then. First they had to give me vitamin k and antibiotics intravenously,. When my INR was back around 1.0 I was wheeled into the operating theatre at 2.30 on a Sunday morning.

My heart rate did increase from about ninety to over 200, so they kept me under anaesthetic for 3 hours longer than was planned and kept me in hospital for an extra two days untill my heart rate was in the normal range.

I also had my cataracts replaced with artificial lenses a year or so before but that was under local anesthesia.

[sanotrader1]

Hi Oscal

To help put you at ease I had the same problem AF and surgery . I just had prostrate removal surgery and when I went in I was in AF and as long as they are aware that you have the condition all is good . My Urologist said it was interesting right when they put me out and for most of the surgery he said I was in normal sinus rhythm. Also I take flec, verap and metoprolol so I'm on max meds for now but it seams episodes have gotten much less after surgery it was a big weight lifted. I'm three weeks out from surgery and doing great . The worst part of prostrate surgery for me was wearing the catheter for a week after but you get used to it .

[Oscal in reply to sanotrader1]

Thanks for that positive feedback.I will press on , may you continue to improve.