Have been offered an ablation & allthough I haven't had my letter I thought I would try & get an idea of waiting times.
18 -20 weeks with sedation.Minimum 12 months with GA.
So who decides? Although the thought of being awake scares me I would certainly choose it do cut down on waiting time.
It would certainly make an ablation procedure more expensive to have an anaesthetist in attendance - so cost could be one thing. The availability of an anaesthetist another.
I had my first two ablations by sedation and the third with a general anaesthetic and I can tell you I much preferred the GA one. My second ablation took 6hrs and for me that was too long to be under sedation. First ablation was three hours and third 5 hours.
Jean
It definitely scares me without GA but too long a wait.
Sedation doesn’t mean being awake - you will be asleep most of the time and have little or no memory of the event.
I suspect the difference in waiting times will be because GA will require full attendance during the procedure of an anaethetist, whilst sedation may not.
The decision should be a dialogue between you as the patient and the EP. Some EP’s just prefer their patients to have a GA whilst others are happy to offer sedation.
I think a lot depends upon you as the patient though. I have now had 2 ablations with full sedation and 2 surgeries with just IV pain relief and very, very light sedation and have been awake the whole time BUT a) it does’t scare me at all and b) I have a high pain threshold and can lie very still and keep myself very calm for long periods. If you struggle with the latter, I think I would really talk to your EP first. Both ablations were 7-8 hours as both PV as I was not able to have cryo and the revision of Pacemaker implant was about 4 hours.
Hope that helps - Best wishes
it helps a lot.I thought it was the type that you were awake but not anxious.That is what I had with stents.
I had sedation to have a hole in my heart closed.They go in via your groin . It took 1 hour for me.I was given small morphine doses along the way.Some having same op. done the same day had a 2 hour sedation op.I had to be very still an I I could do that. Maybe that is something to consider.
I had sedation 3 times and GA 4 times.
GA for me every time.
Pete
Hi thanks for reply .I really don't want to wait over 12 months as I have been in Persistent for 18 months now and EP has agreed longer I wait less chance of working.But will it down to me or the Doctor.
Some people also prefer sedation so it may well suit you.
I understand your concern I had Paroxysmal AF for more than 25 years before things improved for me.
Pete
I had sedation the hospital couldn't afford GA, sedation was better I had no sickness and it didn't take days to recover from the anaesthetic.
good thought never thought of after effects.
Agree with what others have said GA was much better than sedation. My present cardiologist only uses GA as said much more comfortable for patient & if complications etc occur he has the right support to do any extra surgery. Always worth asking to be put on cancellation list - during autumn/winter folk tend to get poorly & I know my hospital are eager to fill them.
I had sedation for my catheter ablation, I was aware of what was going on for a while then things got tricky they upped the sedation and knocked me out, off I went to sleep, woke with no after effects of a GA. I would do sedation again if I needed another catheter ablation, 👍
I have had sedation twice now and I can tell you it really is much better than GA which I have had for other issues. Recovery time is much quicker you can go home earlier and sedation is far less dangerous. With sedation your only slightly aware what’s going on and at times I am sure I was asleep. Felt no real pain either so all in all nothing to worry about regarding sedation and in my opinion a much better option.
I had sedation for both my afib ablation and my flutter ablation. No issues minor pain Went home both days. I would choose sedation if given the choice. Especially if it is much quicker!
hi Katz
I had one with very light sedation and 2 with GA’s.
I did enjoy watching the procedure during the op but I did not enjoy the discomfort since I was fully awake and aware throughout. I was too shy to ask for a top up of the sedation and the EP apologised afterwards when he saw my distress. So my advice is IF you opt for sedation speak up as soon as it becomes uncomfortable.
Also, and this is an age thing, they had to stop half way through the procedure when I was just lightly sedated because I was desperate to empty my bladder. I then had to pee laying flat on my back in front of the entire team! Not an experience Iwould ever want to repeat.
😂😂😡😡
my greatest fear when I had sedation for ablation was needing the loo especially as they fill you full of iv fluids, i was convinced I wanted to go made worse by anxiety. I got them to put a catheter in just to stop me worrying about it. 🤣
thats what I’m worried about, as I can’t hold it much longer than 4 hours. Maybe I could ask about catheter when it's my turn.
I can only imagine your distress at the lack of dignity! A very kind nurse offered me a catheter at pre-op - so thankful!
😳😳😳. Id be mortified. Still, at least it wasnt anything else 😉.
Sedation is OK ! Don't overthink it! . Some say they didn't feel a thing but others like me felt some freezing - it was bearable and all over in a jiffy.
To recap - don't overthink and relax and let the professionals do their work. Good luck
I’ve had sedation twice re. angiogram And when pacemaker fitted. I know pts not the same operation but sedation was fine and preferable to GA. Even allowed me to talk to staff etc.
HI
I would be concerned that no anaesthetist is present.
I have 2 anaesthetists for both operation because I had controlled H/R on second and have had a stroke. AF for both as I am persistent.
I guess if you ever go to A & E you will get it earlier.
cheri JOY. 73. (NZ)
Take care.
I had an internal cardioversion 2 years ago with sedation. Nervous about it but it put me right out just like an anaesethic would, i didn't know anything about the op. I have an ablation scheduled for a months time with the same cardiologist but that will be with an anaesethic.
I've had both and would have sedation again if needed. I did feel things for about the first half hour. The issue for me was that even when I was 'out' I still wriggled in response to the pain. So that 1st procedure didn't work very well. It's a toss up. Evidently my pain response is high. Maybe yours isn't.
I am a queen wuss and sedation was fine! Really. There is an anaesthetist there but it is a shorter procedure and you require less nursing afterwards as you go home more quickly. If they have said you are suitable for sedation, take it. I had really lovely staff monitoring my every comfort (including hot blankets). Go for it!
It will be up to the two of you - your EP and yourself to decide on which you have. What type of ablation are you having? I think most EP's are quite happy with sedation for a cryo ablation. If you EP is saying you can't wait too long then he must be thinking of sedation rather than GA as he knows the wait times? Only thing to do is ask him as soon as you can. I have had both a hip replacement and total knee replacement with sedation and would far rather the recovery from sedation than GA. I had absolutely no problems with either taking in a few CD's for them to put on my headphones during the operations.
Hi i had ga and wasnt given a choice.After 3 hours i was in the hotel bar and having a G&T and something to eat as i hadnt eaten all day .No probs with recovery at all.Discharged 3 hours aftervablation.
I was given no choice. UHCW rarely do ablation under GA, and I was told it is THEIR decision on medical grounds ,not patient preference. So not up to patient to decide.
Yours may be different,and of course,if private,you choose.
I had sedation for my ablation, fell asleep immediately, stirred slightly feeling a slight discomfort then went off to sleep again. I woke up in the ward.
I had sedation for my ablation, whilst it was uncomfortable at times there was no pain, the most uncomfortable part was lying on the table for 4 hours they are hard, I fell asleep towards the end of the procedure and woke up on the ward,
Like someone else said no after effects of a GA so home the next day and then REST REST REST to give your heart time to heal.
That was 4 years ago and still AF free
All the best
I had my first ablation with sedation.
Then the following 2 ablations under G/A.
Some folk don’t mind the sedation, but I found it a terrible experience.!!!
Funnily enough I recovered quicker after G/A than I did the sedation which surprised me. I was groggy for 2 days with the sedation but felt ok morning after G/A.
Hi I've had 2 ablations both with sedation. I know nothing about any of the procedures because the drugs they use wipe your memory and pain. So although Ive been told I've been awake and talked to during the process I have no recollection of it. So I'd go for sedation
Hi, not much to offer, I had an ablation whilst in hospital, trying to find out what my problem was. Didn't really know much about it but when it was offered I said, lets do it, as I was a bit sick of it all. Know now that I had a top EP and I just went with it. Sometimes, maybe, ignorance is bliss, had sedation and felt very safe and being well looked after. Hope all goes well for you, I would have it again in a heartbeat but hope it's not necessary.
I had an ablation privately in 2014, and one ofthe biggest issues for me was not sedation - I was all in favour of that rather than GA - but fluoroscopy. I did not want to be exposed to radiation for hours on end (my mother and aunt had both worked in radiology in the early 50s at the same hospital and worked with an X-Ray machine that it transpired much later had been mis-set at the factory and spewed out radiation, to their later cost - and that of my elder cousin - so I figure I have had my life-time dose).
Fortunately, my cardio and I were of a mind on both counts. She came from Europe, where sedation rather than GA was normal. And she also said she wanted kids someday too, so was not keen on extended fluroscopy herself. In the end she cut it down to under 10 minutes of X-Rays for catheter ablation PVI surgery that took several hours. Which was unusual then and apparently set a new pesonal record she was quite proud of.
To your point though, we were both frustrated on the sedation front and had to use an anaesthesist. There was no choice. I rather think it is because it was pretty much a closed shop at that hospital. The anaesthesists just had to get their nose in. And, of course, there are a very finite number of anaesthetists, because the professional body deliberately restricts supply. I knew an anaesthetist who had to retake her exams for admission to the upper echelon of the profession several times (at some considerable cost) not because she was especially bad at her job but because that was the norm, the exams serve to keep down supply - and after all "who wants a anaesthetist who only got 93% on their exams?"
In my case an anaesthesist came around to introduce himself the afternoon I was due for surgery, which I thought was decent of him. I am always particularly keen to urge caution upon them in shunting the breathing tube down my throat, because not infrequently the most uncomfortable part of an operation is the sore throat you can have for days afterwards.
But then the surgery was postponed anyway until the next morning, when my cardio would be 'fresh'. Which was a shame because I had been incarcerated since 7am just waiting in a gown in a bedroom with builders using jackhammers on the scaffolding outside. No kidding!
And, the next day, a completely different anaesthetist was there, a young guy I saw as I counted down. Afterwards, when my cardio visited, my ablation catheter entry wounds were OK, but she noticed my arm was black and blue where the IV had gone in. She must have raised the issue because then another middle-aged anaethetist I didn't recognise turned up to examine the damage, almost as if he had not seen it before, and made a point of declaring "I did this", in a rather odd way, which allowed no demur (and I'm quite sure would be backed up all around) but made me wonder whether there wasn't some degree of understudying going on for tyro anaethesiologists to get experience, or maybe just stand in, claim hours, or whatever. Who knows? What is a major event and mystery to us is 'just another day at the factory' for medics.
So, I suspect there are very different economics between the private and the state sectors where strict need for anaethesiology is concerned. Even (or especially) in a hospital where they can do both, each way. And it likely comes down not even so much what the operation technically needs so much as what the provider, insurance company or patient will pay for.
On which note, of course, I was discharged that same day, fairly unceremoniously and with some alacrity. And took a tube home, still bleeding into my underwear. Because, naturally, I had shot that one night the insurer would pay for on their standard tariff, without further explanation (which is a no no for medics apparently), through having my op delayed by a day.
I had sedation for my ablation and was never offered general anesthesia, and if I had I think I would have declined it. The sedation was perfect. I was aware of nothing and felt nothing. I was slightly sore when I came to, but even that was not a big deal. I would think the doctor performing the procedure decides if sedation of general anesthesia is needed, since the doc should have a good idea of what needs to be done. If the doc suggests sedation, I would think you should be totally fine.
I see here some have had ablations that lasted quite a long time. I think mine was about an hour. Again, ask your doctor what he thinks the best solution is as he should have an idea of about how long it will take.
I wish you the best whatever you decide. I don’t think I’m brave enough to go with sedation although that’s what you have when they do the catheterization. I did not feel anything during that period if that is how they are doing your ablation it might not be so bad. I have had work done on my spine with just local. Then again the heart is the heart I hope someone here can tell you that they’ve had it and felt nothing. You’re brave to consider and I understand the waiting period makes you want to give it a try. It always amazes me how long you all have to wait in the UK. I’m sorry you go through that.
🙏🏻❤️ I am sure someone out here has done what you are considering they can tell you truthfully
I had my first ablation 8 days ago with GA (my choice). The wait time for GA was only 6 - 8 weeks longer than sedation but I guess this varies with different health authorities. I was very glad I insisted on GA as my procedure included a TOE - the prospect of which horrified me! My ablation started about 1pm and I went home around 8pm with no issues at all from the anaesthetic. I am very impressed with the bravery of those who opt for sedation.
I had sedation for mine last year but I think Im particularly resistant to sedation as I screamed during a cardioversion once and when they were part way through the ablation, I asked when they were going to sedate me and was told they already had 😄.
They did have to cardiovert me twice during the ablation and fortunately were able to zonk me out for those.
Risks are higher with GA so I would guess thats part of the reasoning with giving sedation.
I have had 3 ablations and one aborted abruptly due to rare complication. Only one of them was under GA .
I had no choice in the decisions. Hospital policy was to do them under sedation unless there were reasons to do it under GA. I had a variety of experiences with sedation and looking back I think it is really important for me that I am kept informed about what is happening so I know what to expect. I have only ever experienced discomfort rather than pain and for me that is bearable if I know in advance . Last time I used meditation and that really helped my anxiety.
Having a GA takes a lot of anxiety away but there is a much longer recovery period and there is always a longer waiting list . My EP. only had access to an anaesthetist once a week.
If you are concerned about your AF worsening while you wait, I would go for the quickest option. However, your post reads as though the decision isn’t yours? The EP might make his decision on whether he thinks you will be able to keep still, I believe that some prefer their patients to have GA in order to guarantee stillness.
Whatever decision you are given, I wish you All the very best. X
I had my ablation done with sedation, at the end of July, the consultant had to talk to me as the morphine made me, er somewhat happy, and I was singing a song and trying to dance😳🤣. I was sedated for 5-6 hours , I felt discomfort like a bad period pain ( but in my heart obviously), I remember stirring from the sedation and groaning, this was then followed by the consultant saying more sedation please. I didn't have a choice, but the consultant said they cant offer GA to everyone as the waiting lists would be huge. I had a EP study at the end of the year, last year, I was scared about the ablation as I found the EP study a bit traumatic when they triggered AFib. However it honestly was okay ❤️
that's a long wait if you have GA - which area is your hospital?
Sedation or General Anaesthetic?
General Anaesthetic worries
Paroxymal AF and a general anaesthetic 
Short general anaesthetic 
