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Ablation for Atrial Fibrilation

Heart Rhythm Conditions | Last Active: May 12 4:21pm | Replies (30)

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@gloaming

I am glad to help you with MY experience, and you'll find that much of it is shared across patients. But, we're all individuals with our own care providers, spouses, histories, interests, and fears. So, I'm afraid this will have to be your own private journey. It helps to have a loved one at your side to drive you home from the odd diagnostic where you might need sedation. An angiogram, for example, if you require or with to have sedation. I didn't, and it was a piece of cake. The worst, and this is the same for the actual ablation, is having to lie still with a heavy bag or compression on the inner thigh where the incision for the catheter is. This lasts for at least four longish hours.

The procedure, for me, was largely painless. In my case, the worst for my first ablation (they were seven months apart, and I'll get to that...) was awaking with a thoroughly parched throat. If they use a a trans-esophageal echocardiogram (TEE), it goes down your throat after you're out. It helps them to keep the burning needle away from your esophagus, and to see where the needle needs to be placed for the various burns. I believe they use an agent to keep your saliva production to a minimum (not positive about this), but it was truly miserable for about an hour after I regained consciousness. I told the anaesthetist this when he came by for my second ablation, and he seemed quite pleased to be able to improve my recovery experience....and he did! The difference was huge.
In case you've not done much reading, about 75% of index, or first, ablations succeed. That means about 25% fail. It's tricky trying to find the various foci where your unwanted beats are coming from, so most index ablations just concentrate on the 80% probability that it is the typical voltages emanating from the pulmonary vein ostia at the rear wall of the left atrium. These get zapped first, and are always included because that's where so many of the unwanted signals enter the atrium and cause ectopy. But there are other places, including inside the atrial appendage, the Vein of Marshal, and other places around the inner lining of the atrium. These have to be found, but if you're not fibrillating, and don't start while they're inside your heart, they may never find them. This means a second, or touchup, ablation after a few months. Happened to me.

Honestly, it 's mostly the disruption of routine, for me, that is the worst part of any intervention like that. Sitting around in a hallway, driving long distances, staying at a motel, eating restaurant food...I'd rather not, thanks very much. The procedure is done quickly, within 160 minutes typically, and you wake up with a stern nurse telling you not to move. And, you don't. In three hours, they'll make you eat and drink, and at four hours you get up and walk around while pushing your IV tree. If you can keep stuff down, and walk for 10 minutes, they call your second and they'll be in the hallway to take you out to the car.

This is not a sweatable procedure. For me, I couldn't wait. Honestly, I was giddy when my EP told me he would do my procedure. I knew that it was the only way to halt the unwanted symptoms and the progression to more advanced arrhythmia. Happily, the second ablation took, and I celebrated a year free of ectopy last February. It should also happen for you. Count the days, my friend. Count the days!

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Replies to "I am glad to help you with MY experience, and you'll find that much of it..."

What a generous and helpful response. Thank you! Fingers crossed.