Ablation under sedation: Can I get an... - AF Association

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Ablation under sedation

Modog profile image
Modog

Can I get an ablation under conscious sedation. I’ve always been fearful of anesthesia.

34 Replies

I did it wasn’t a pleasant experience

BobD profile image
BobDVolunteer

If cryo yes. RF is usually under GA. which is much preferred by most people. Much nicer not to be there when it is going on.

Jackyg profile image
Jackyg in reply to BobD

Exactly. U are still semi awake. When they punched into the right side of my heart I felt it, even under sedation.

Ducky2003 profile image
Ducky2003 in reply to Jackyg

Had my ablation 3 weeks ago and remember that moment quite vividly!

You can, ….but having had 2 ablations last year first sedated second general a I would say it is worth overcoming your fear ( mine was a terror) of general anaesthetics

The G A was much better

My first 2 were under sedation and the 3rd was under GA. I recovered much better under sedation and the experience really wasn't that bad at all even though these were about 4 hours long. These were in 2009 and 2011 and GA in 2013. I've got another coming up shortly and if I have a choice I may opt for sedation.

I've had 3 RF ablations, the first two were under sedation, last one was under GA and I far preferred that.

I had it done last year with an issue. Strange watching the large TV monitor while they worked on me but I was fine with it.

I had both Cryo and RF under a GA. there’s no way I wanted to be awake whilst they did their work. I wasn’t sure I would be able to keep still all the time (even with sedation) especially if it was uncomfortable and didn’t want to be a hindrance to the EP whilst they were doing delicate work. I’m also a coward and wanted to be out of it. x

I've had 2 ablations both under sedation.... no problem at all. Only slightly aware of what was happening. Felt absolutely fine afterwards.

I had 3 ablations by sedation however I had a bad time with last one being aware when they performed a Cardioversion in the process. For that reason I had the next 4 more ablations by GA.

I would recommend GA over sedation a number of my procedures took over 5 hours.

Pete

Ducky2003 profile image
Ducky2003 in reply to pottypete1

I had my abblation 3 weeks ago and they had to cardiovert me twice. Not great hearing them saying they were going to do it. I'm quite resistant to sedation so they had already given me as much as they could. At one point, I remember asking when they were going to give me sedation and they already had 😁.

pottypete1 profile image
pottypete1 in reply to Ducky2003

Sounds very familiar to me.

Hope you are taking it easy and slowly getting back to normal (whatever normal is🤭).

GA for me every time.

Pete

Ducky2003 profile image
Ducky2003 in reply to pottypete1

Yes, taking it steady. For my first cardioversion 4.5 years ago, they didnt sedate me adequately and I screamed the place down. Hubby was sat in the ward next door reading his paper and said the other folk waiting for theirs, had the colour drain out of their faces. Needless to say, for subsequent ones, they've doubled the dose 🤣.

I had two ablations under sedation, the first a PVI CRYO ablation for AFIB, the second an RF ablation for A flutter. Neither a problem with sedation. In fact I found the former very interesting as I could watch what was going on on some of the large monitor I was lying next to.

The level of the sedation can be increased if necessary. I did not need it.

The groin is a local anaesthetic. I felt no pain at all during the procedure.

The pain for the PVI cryo CRYO ABLATION is felt in your head, it is exactly like the brain freeze from biting into a very cold ice cream. 4 times, one for each vein, with a lot of time in between veins where they relocate the catheter.

The RF flutter ablation I had was in the right atria and was not a big job , the pain was a little bit more intense again not in the chest but in the right shoulder.

I have had worse at the dentist.

I had a bit of pain in the chest at the end of the cryo procedure where I felt just like I had swallowed a big mouthful of something and it had got stuck. A glass of water just after the procedure removed most of that, and as soon as I was on the ward after the hour or so in the recovery room I was eating chicken and stuffing sandwiches!

Best wishes

Ducky2003 profile image
Ducky2003 in reply to KMRobbo

I remember reading about your sandwiches (think you said you took them in yourself) . I ended up with ham but as I was in a private hospital (on the NHS) they were freshly made and came with a side salad 😁.

KMRobbo profile image
KMRobbo in reply to Ducky2003

Posh or what? 😁

Ducky2003 profile image
Ducky2003 in reply to KMRobbo

I still think I would have preferred the chicken and stuffing. To be fair though, I was still semi recumbent at that point as the groin was still bleeding so anything that didn't choke was good 😁.

I had sedation during cryoablation, was a little uncomfortable but to be honest I think I was asleep through most of it. If they know your very uncomfortable they can give you a little more sedation. Recovery time quicker also.

I had my first PVI ablation carried out under sedation and it was not nice.!!!! I opted for general anaesthetic for my other procedures and it was brilliant. Fall asleep, wake up job done.👍👍

I had RF ablation 5 weeks ago tomorrow under sedation. You will feel it - and it depends on how much analgesic your body can take. I apparently moved in response to the pain. I do remember some of it but I don't feel traumatised about it. The issue with a pain response is that they need you to keep still, very still, and for that reason I personally might need to have my procedure repeated. Which is a bummer. If you're stressed about a GA then I'd seriously consider having sedation. I've had worse pain and if I had to have it again under sedation, I would.b

Hi ModogNice name by the way, I have had 3 ablations. The first was with sedation but it was a relatively straight forward ablation into the right side of the heart for SVT. It was just awful. I felt everything even though I was distracted and fascinated by all the machinery and actually seeing the catheter snake its way into my heart. It was 3 1/2 hours of hell.

When I was scheduled for a further two ablations, this time knowing they had to punch through the septum to get into the left side of my heart, there was absolutely no way I was doing that with just sedation. So I opted for full GA.

From past experience I know that I’m not good with general anaesthetics. True to form, I went i to shock after the first GA BUT when I discussed this reaction with the anaesthetist before my second GA he changed the anaesthetic and also had my wrapped in a ‘bear hug’, a sort of heated bubble wrap, and everything was amazing.

My message is to talk to your anaesthetist and make him aware of your fears.

My pulmonary vein isolation first ablation was sedated. It was easy-peasy. Some odd sensations and some pain in face at times, but nothing too long or too awful. Recovery is obviously quicker immediately afterwards too.

Second one was a mapped one so had to have a G A.

Hope this helps

I had a local anaesthetic and it was fine. I drifted off for about 45 minutes came to when there were the final ten or twelve bursts of RF. No pain, perhaps just a slight pushing sensation. They said 'all done' and I got off the bed and walked back to the ward. After a bit I was offered a cup of tea and then a sandwich which I wolfed down.

I didn't have to lie flat for hours and I wasn't bored which was my main worry. The only problem I had was when I stood up to go home and my blood pressure fell and I didn't feel too good. Once I was back on the bed I felt fine. It took three quarters of an hour for it to go up again, then I went home. I wonder if this happens to many people.

I wish I had the choice. Personally would prefer to have GA,as the anesthetist is there watching over you,I fear I may not be able to lie still as I have neck problems.

I understand your reluctance but perhaps talk to your specialist and see what they may suggest.

Best wishes

My RF PVI was done under sedation, as my EP prefers that. It was fine, and I can't remember much of it. I know at one point they all shouted 'don't move' at me. When they were doing the burning, I felt a slight pain a couple of times but when I mentioned it they gave me more analgesia. It didn't seem very long to me, but it was 5 hours. Was terrified beforehand, but all the staff were lovely and reassuring. I would definitely have it done that way again if I need another. I'm very wary of GA. My last one was for my cardioversion in 2019. It took my kidneys 2 days to wake up afterwards, no weeing is not good. I put on 12 lbs in water weight and developed a horrendous UTI which needed 2 lots of antibiotics. Definitely don't want another GA.

Palpman profile image
Palpman in reply to Ecki

My last GA was for my gallbladder removal and I also could not wee for 24 hours. Seems it affects men over 60 the most.Luckily my lift home was late enough to detect the problem. Had a catheter inserted and 1,3 litres of urine came gushing out. What a relief.

Ecki profile image
Ecki in reply to Palpman

Interesting, although I'm not a man but I am well over 60. No bladder pressure for those 2 days because there was no urine coming from the kidneys, bit scary wondering when/if they were going to start working again. Been fine since.

I had my cryo and RF ablations under heavy sedation there was no option for general anisthetic. It was OK - Im guessing that most hospitals prefer sedation as its less risky and can bring you around temporarily if they need any response from you during, as mine did for a short period for the cryo to ensure that my nerves were not being damaged when they were freezing close bye

Lordy I think this will be the next procedure for me and absolutely without a doubt, I'll be asking for a GA. There's not a hope in hell that I'd be ok with sedation. Fear results in me shaking totally uncontrollably and as someone said, I wouldn't want to hinder what they are doing. We are all different of course but I've no problem saying I'm not brave enough!!stay well all,

Blue :-)

First ablation under sedation in 2015. Must confess to being pretty nervous, especially as I’m no good at keeping still under stress, but it was ok, nodded off a few times and the staff brilliant. The bang of an unexpected cardioversion at the end was a bit of a shock 😄 but afternoon tea later and plenty of inner false bravado. No choice second time around a year later - it was a GA and much preferable especially as it included the camera exam- can’t remember the medical term. I’m lucky to be under a brilliant and charming EP with a great team - although my P AF has returned lately it eventually gave me a good 3 to 4 years AF free. Incidentally EP reckoned each ablation costs the NHS about £5,000 so you get your money’s worth.

I had my combined RG and cryo ablation under sedation. I was asleep most of the 5 hours it took but woke up once or twice. That was OK and the recovery much faster than a GA. Also no long term side-effects like you can get with GA.

I had ablation for AF and SVT under sedation. My vein collapsed so only some of the sedative was getting into the blood stream but no one realised for a while I was in quite a lot of discomfort and very awake! Once they realised they put in another line but it was impossible to tell how much sedative I had already received so they gave me another full dose which resulted in me being impossibly sleepy and having to stay in overnight. I wasn’t given any choice but I would choose GA if I had to have another ablation! Rowena

A lot will depend on the hospital. They each have their preferred methods. Have a chat to your EP

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