Question about sedation/GA

[cgryan888]

Hello everyone,

I have been reading this forum for quite a while now and find it extremely helpful. I do have a question that some may be able to answer.

I had an ablation (first) in December, and when I finally went in after getting strapped in (so to speak) I asked when I would be sedated. I was then told I would not be sedated as (and I'm paraphrasing here) as in their experience a quicker, more successful outcome could be achieved without. I explained that I was told otherwise, and eventually they gave me something, although not very effective.

Still, has anyone else ever been told this?

cgr

[gorpo59]

You'll always be sedated, it's just a matter of degree. Usually quite pleasant!

[mjames1]

It varies by ep and also by geography. In the US, for example, General Anesthesia (GA) or heavy sedation is the standard. In the UK and Europe, conscious sedation is a lot more common.

From a patient perspective from here and elsewhere, some prefer GA and some conscious sedation. My preference is conscious sedation, because the GA drugs can linger for quite some time, especially for seniors.

Jim

[JOY2THEWORLD49 in reply to mjames1]

Hi

Yes Jim.

After GA I have constipation for exactly 6 weeks!

I'm loaded with figs, prunes, fruit, my glycerin suppositories, colofac, licourice but not good for my thyroxin I take for thyroidectomy. I need to take more.

cheri jOY. 75 (NZ)

[cgryan888 in reply to mjames1]

Thank you Jim for your response. My apologies if my post wasn't clear. The particular EP I had prefers not to use any sedation (conscious or otherwise), so my question really was whether anyone else had experienced this, as the ablation process was quite contrary to anything I had heard or expected.

cg

[50568789 in reply to cgryan888]

I find it a bit unsettling that you were not going to be given anything (mostly because I'm on an ablation waiting list and a bit apprehensive). I've been told I would have sedation but not GA. What was the procedure like for you?

[cgryan888 in reply to 50568789]

Please don't be apprehensive about it. The reason I posted was because it seemed highly unusual not to be sedated. It doesn't seem to be most people's experience. As this forum also shows people have quite different experiences, so I'm sure you will be fine.

[Jajarunner]

I was sedated but I didn't feel any different! Although the 90 mins did pass quickly so maybe I was more out of it than I remember! It was all so interesting with what they were doing and the big map of the heart on the screen and the weird sensations so perhaps that made the time fly? Better recover than GA too (the next two ablations were GA).

[BorderMLH]

yes I was told the same, I ended up with a sedation where I was awake. I had complications and had to stay in overnight, I was told if I needed another one, I would have to have a GA as the instruments are much more invasive (I had a bleed out) & left being anaemia & pericarditis. I was told to have the latter, often meant a successful ablation. 6 months on, I have now been taken off apixaban & only take 1.25 of bisoprolol a day! Good luck! Xx

[PCC62 in reply to BorderMLH]

Hi BorderMLH. I'm interested to read that you've been taken off apixaban. Do you know your CHAPS score or may I be so bold as to ask what age you are? I've had a successful (so far anyway) ablation and was hoping to be taken off apixaban but my EP says that although my CHAPS score is 0 and I'm 61, the risk increases at 65 and might be wise to remain on the meds. Thanks.

[Buzby62 in reply to PCC62]

PCC62, I was about to ask the same question, how long ago was your ablation? Mine was December, see my bio.

[PCC62 in reply to Buzby62]

Hi Buzby62 - mine was December as well. I had a pulse field ablation. How are you doing? By the way are you based in Wales? Only reason I ask is I'm literally on a train to Cardiff now and thought I spotted a Welsh flag in your bio!

[Buzby62 in reply to PCC62]

Apart from the one episode which self terminated, I’ve been really good so far, almost afraid to say 🤞yes, about 40 mins west of Cardiff. I was interested in PFA but wasn’t available here yet. Waiting for a date for 3 month review to discuss medication withdrawal if things stay as they are. My EP was talking about stopping apixaban and bisoprolol if successful and gave me a prediction of 60% chance.

Not to hijack this post, I had sedation for cryoablation and 2 hours passed in what felt like 15 minutes, wouldn’t like the thought of no sedation at all though.

[BorderMLH in reply to PCC62]

Hi there, yes my score is 0. I am 54 and have suffered with AF for a number of years. I was taking aspirin off my own accord after stopping the apixaban , but was told as my score is now 0, there is no need to take that

[PCC62 in reply to BorderMLH]

Thanks BorderMLH. You've got age on your side! Sounds like a great outcome. Congrats & long may NSR continue.

[BorderMLH in reply to PCC62]

Many thanks 🙏 good luck to you too 🥰

[cgryan888 in reply to BorderMLH]

That's interesting isn't it - maybe it is not that unusual. Thank you for your response!

cg

[wilsond]

Not told but had no sedation and minimal pain relief ( until I protested) totally unexpected and unsettling. I was told I'd have both ,it was on my notes but was wide awake.

If I have to have a follow up ablation,I will have firm instructions put on my notes and if I'm not sedated will stop the procedure until I am!

[cgryan888 in reply to wilsond]

Yes, I think the problem for me was that I was told on 3 separate occasions that I would be sedated. I was even told what I would be given. My point is that patients should be reliably informed of exactly what is going to happen - at least then I would have been mentally prepared.

[wilsond in reply to cgryan888]

Exactly! I had no fears going in,bit nervous obviously but was quite shocked.

[pottypete1]

I had sedation for 3 ablations the last of which was very ineffective and very very stressful

I went on to have a further 4 ablations under GA.

I must say that in my case the ablations each lasted between 4 & 7 hours.

I have now been free of AF for just short of 3 years so feel it was all worth it, although it didn’t really seem that way at the time.

Pete

[wilsond in reply to pottypete1]

I was told,like cgryan,that I would be sedated,but wasn't. EPs choice but not told. I kept wondering when it would kick in.....

[needlestone]

I was given light sedation. I watched everyone around me and felt pressure but not painful. I was kind of glad I was awake, After my ablation they wheeled me out of the room and the nurse told me I wouldn’t remember anything, but I do.

[Speed]

Difficult to comprehend that they would attempt with not even sedation, even if it would make resourcing easier. I had mild sedation and was in and out of consciousness but when it became very uncomfortable, they gave me a top up as soon as I mentioned it. Not sure I’d have been happy to continue without.

[cgryan888 in reply to Speed]

Yes Speed, that's what I was expecting. Nonetheless, most on here seem to have your experience, so that's good as I would not wish to put anyone off having an ablation.

Thank you for your reply.