Having First Ablation: What to Expect

Posted by rainyday541 @rainyday541, Feb 18 9:34pm

Cardiologist recommends ablation for AFIB. I've never had an ablation. What is the process? What is the procedure? What should I expect? Looking to someone to educate me on ablations.

Hi rainyday!
First, I've got to say I'm really surprised your cardiologist didn't "talk" you through the procedure. That doctor would have lost major points with me for that oversight. (Perhaps, as a retired RN, my expectations are a bit more demanding)

When you ask "what is the process?" I'm not entirely sure what you mean by that. If you mean how did you arrive at the point your cardiologist recommended an ablation, then the question is fairly easy to answer.

Once a diagnosis of AFIB has been reached, depending on the type and severity, there ARE options. I was not a Cardiac RN, so from this point on, I am speaking ONLY as a patient, diagnosed with paroxysmal AFIB, who underwent an ablation one year ago.

After I received my diagnosis, my cardiologist did a complete work up…..blood work, stress test and an MRI because of my age (68) and other risk factors I had for stroke, which is a major concern for those of us with AFIB.

I was immediately put on blood thinners to lower my stroke risk. Since my AFIB episodes were, at that time, fairly random and stopped on their own, my doctor held off prescribing antiarrhythmics ( a drug that regulates your heart rate).

This regime worked pretty well for about a year, but eventually the episodes of AFIB became more frequent, lasted longer and my heart rate during an episode became much higher. I was put on an antiarrhythmic medication which had unacceptable side effects for me. We tried a different drug with very similar results. It was at this point my cardiologist began talking about an ablation.

He talked to me in great detail about the surgery, the procedure, the possible outcomes and the recovery process. I was definitely nervous, but perhaps not quite as much as most people. NOT because of my medical background, but because I had already had two stents placed in my coronary arteries due to plaque buildup. So, I was at least a little familiar with the laparoscopic procedure, the somewhat scary environment of the cath lab and the recovery procedure which are very similar. (My stents had been placed about 8 years before the AFIB showed up)

When it was decided, between my cardiologist and myself, that antiarrhythmics were not going to work for me, he sent me to see an EP. An EP is a Cardiac Electrophysiologist, a cardiac surgeon who specializes in abnormal heart rhythms. If you think of your heart as an engine, which has to run extremely well, think of your EP as a top notch mechanic!

A few weeks later I had a one hour consultation with the EP my cardiologist recommended. He had all my test results and agreed with my cardiologist (AND ME) that an ablation was the best next step. He discussed the procedure from the moment I walked into the hospital through my discharge the next morning. He answered every question I had……even the ones I had already asked several times. I believe I was incredibly lucky to have an EP who understood how frightening this procedure was to most people and his patience and compassion were outstanding!

To write about the procedure in detail, the hospital recovery period, my recovery at home and the three months of follow ups to find out if the ablation was a "success," would make this post look like the first draft of a novel. So…..I'll spare you that.

I would strongly recommend you discuss ALL of these questions with your cardiologist and/or EP. But to learn the basics about the procedure, I suggest you check out some websites (I KNOW….I KNOW! USUALLY THE WORST ADVICE ANYONE CAN GIVE) But………if you go to the RIGHT websites, you will get a great deal of accurate, up to date information about AFIB and the procedure will be explained in detail. I will post a couple of trustworthy websites, but you will also be getting a lot of great answers, and reassurance from many people on THIS site who have undergone ablation and sometimes, more than one. (Don't let THAT scare you!) Next month, on the 20th, will be my one year anniversary of MY ablation and I'm very happy to tell you that from day 3 post surgery to now, I have not had ONE SINGLE EPISODE OF AFIB!!!!! The only medication I am still on is a blood thinner and that's just a given when you have AFIB. (I should have mentioned this earlier, but you need to understand that AFIB is not "curable." It IS highly treatable. Your EP will explain this to you)
Websites:
1) https://www.mayoclinic.org/tests-procedures/atrial-fibrillation-ablation/about/pac-20384969

2) TYPE IN………. cardiac ablation videos mayo clinic

These two sites alone will give you many answers and prompt you to ask your doctor pertinent questions.
Other websites include the Cleveland Clinic and UC Berkley.

If you have further questions, just post them here……we'll be here for you!

RubyWitch

REPLY
@rubywitch67

Hi rainyday!
First, I've got to say I'm really surprised your cardiologist didn't "talk" you through the procedure. That doctor would have lost major points with me for that oversight. (Perhaps, as a retired RN, my expectations are a bit more demanding)

When you ask "what is the process?" I'm not entirely sure what you mean by that. If you mean how did you arrive at the point your cardiologist recommended an ablation, then the question is fairly easy to answer.

Once a diagnosis of AFIB has been reached, depending on the type and severity, there ARE options. I was not a Cardiac RN, so from this point on, I am speaking ONLY as a patient, diagnosed with paroxysmal AFIB, who underwent an ablation one year ago.

After I received my diagnosis, my cardiologist did a complete work up…..blood work, stress test and an MRI because of my age (68) and other risk factors I had for stroke, which is a major concern for those of us with AFIB.

I was immediately put on blood thinners to lower my stroke risk. Since my AFIB episodes were, at that time, fairly random and stopped on their own, my doctor held off prescribing antiarrhythmics ( a drug that regulates your heart rate).

This regime worked pretty well for about a year, but eventually the episodes of AFIB became more frequent, lasted longer and my heart rate during an episode became much higher. I was put on an antiarrhythmic medication which had unacceptable side effects for me. We tried a different drug with very similar results. It was at this point my cardiologist began talking about an ablation.

He talked to me in great detail about the surgery, the procedure, the possible outcomes and the recovery process. I was definitely nervous, but perhaps not quite as much as most people. NOT because of my medical background, but because I had already had two stents placed in my coronary arteries due to plaque buildup. So, I was at least a little familiar with the laparoscopic procedure, the somewhat scary environment of the cath lab and the recovery procedure which are very similar. (My stents had been placed about 8 years before the AFIB showed up)

When it was decided, between my cardiologist and myself, that antiarrhythmics were not going to work for me, he sent me to see an EP. An EP is a Cardiac Electrophysiologist, a cardiac surgeon who specializes in abnormal heart rhythms. If you think of your heart as an engine, which has to run extremely well, think of your EP as a top notch mechanic!

A few weeks later I had a one hour consultation with the EP my cardiologist recommended. He had all my test results and agreed with my cardiologist (AND ME) that an ablation was the best next step. He discussed the procedure from the moment I walked into the hospital through my discharge the next morning. He answered every question I had……even the ones I had already asked several times. I believe I was incredibly lucky to have an EP who understood how frightening this procedure was to most people and his patience and compassion were outstanding!

To write about the procedure in detail, the hospital recovery period, my recovery at home and the three months of follow ups to find out if the ablation was a "success," would make this post look like the first draft of a novel. So…..I'll spare you that.

I would strongly recommend you discuss ALL of these questions with your cardiologist and/or EP. But to learn the basics about the procedure, I suggest you check out some websites (I KNOW….I KNOW! USUALLY THE WORST ADVICE ANYONE CAN GIVE) But………if you go to the RIGHT websites, you will get a great deal of accurate, up to date information about AFIB and the procedure will be explained in detail. I will post a couple of trustworthy websites, but you will also be getting a lot of great answers, and reassurance from many people on THIS site who have undergone ablation and sometimes, more than one. (Don't let THAT scare you!) Next month, on the 20th, will be my one year anniversary of MY ablation and I'm very happy to tell you that from day 3 post surgery to now, I have not had ONE SINGLE EPISODE OF AFIB!!!!! The only medication I am still on is a blood thinner and that's just a given when you have AFIB. (I should have mentioned this earlier, but you need to understand that AFIB is not "curable." It IS highly treatable. Your EP will explain this to you)
Websites:
1) https://www.mayoclinic.org/tests-procedures/atrial-fibrillation-ablation/about/pac-20384969

2) TYPE IN………. cardiac ablation videos mayo clinic

These two sites alone will give you many answers and prompt you to ask your doctor pertinent questions.
Other websites include the Cleveland Clinic and UC Berkley.

If you have further questions, just post them here……we'll be here for you!

RubyWitch

Jump to this post

Thank you for the helpful information.

I have had AFIB for about 12 years. I rarely have had an episode over the years but during the last 6 months, I have had AFIB about once a month and each time it lasts longer. In the last year I lost 40 pounds and my heart rate is under 50 about 50-55% of the day so I scheduled time with the cardiologist. He reduced my Sotalol from 120mg 2X daily to 80 mg AM and 120 mg PM. Three months later, I went in for a recheck and my cardiologist recommended I see a Cardiac Electrophysiologist and he sent a letter of referral, but I have not received a call from them yet. The Cardiac Electrophysiologist is 500 miles away.

So, looking for information before I travel for my appointment. I appreciate your help!

REPLY

@rainyday541 Hi i have had quit a few Ablations but my Heart had a much more serious problem. Mine was not Afib and from reading lots of post here on connect Afib seems to do well with ablations. My issue was a fast heartbeat called Vintricular Tacrocardia but the actual process of an ablation starts basically the same. Depending on the EP Doctor he will probably get you set up in the cat lab which requires lots of pads on your body that are used to Map your heart. Then depending on if he wants you awake or asleep will come in prior and decide if you will be in a twilight type awake mode or out completely then they will start mapping your heart to see what electrical paths in your heart puts you into Afib. If he or she is able to see some will then start the ablation portion which requires inserting cathetars in either your groin or sometimes other access ports on the neck or wrist. For me most times i was totally asleep for this part and some of mine took hours. I have had more than i care to remember but all of them went smoothly and i would wake up to usually having to spend 4-6 hours flat on my back while the incisions in my groin started to clot. That's basically the process please ask any questions you may have.

REPLY
@rubywitch67

Hi rainyday!
First, I've got to say I'm really surprised your cardiologist didn't "talk" you through the procedure. That doctor would have lost major points with me for that oversight. (Perhaps, as a retired RN, my expectations are a bit more demanding)

When you ask "what is the process?" I'm not entirely sure what you mean by that. If you mean how did you arrive at the point your cardiologist recommended an ablation, then the question is fairly easy to answer.

Once a diagnosis of AFIB has been reached, depending on the type and severity, there ARE options. I was not a Cardiac RN, so from this point on, I am speaking ONLY as a patient, diagnosed with paroxysmal AFIB, who underwent an ablation one year ago.

After I received my diagnosis, my cardiologist did a complete work up…..blood work, stress test and an MRI because of my age (68) and other risk factors I had for stroke, which is a major concern for those of us with AFIB.

I was immediately put on blood thinners to lower my stroke risk. Since my AFIB episodes were, at that time, fairly random and stopped on their own, my doctor held off prescribing antiarrhythmics ( a drug that regulates your heart rate).

This regime worked pretty well for about a year, but eventually the episodes of AFIB became more frequent, lasted longer and my heart rate during an episode became much higher. I was put on an antiarrhythmic medication which had unacceptable side effects for me. We tried a different drug with very similar results. It was at this point my cardiologist began talking about an ablation.

He talked to me in great detail about the surgery, the procedure, the possible outcomes and the recovery process. I was definitely nervous, but perhaps not quite as much as most people. NOT because of my medical background, but because I had already had two stents placed in my coronary arteries due to plaque buildup. So, I was at least a little familiar with the laparoscopic procedure, the somewhat scary environment of the cath lab and the recovery procedure which are very similar. (My stents had been placed about 8 years before the AFIB showed up)

When it was decided, between my cardiologist and myself, that antiarrhythmics were not going to work for me, he sent me to see an EP. An EP is a Cardiac Electrophysiologist, a cardiac surgeon who specializes in abnormal heart rhythms. If you think of your heart as an engine, which has to run extremely well, think of your EP as a top notch mechanic!

A few weeks later I had a one hour consultation with the EP my cardiologist recommended. He had all my test results and agreed with my cardiologist (AND ME) that an ablation was the best next step. He discussed the procedure from the moment I walked into the hospital through my discharge the next morning. He answered every question I had……even the ones I had already asked several times. I believe I was incredibly lucky to have an EP who understood how frightening this procedure was to most people and his patience and compassion were outstanding!

To write about the procedure in detail, the hospital recovery period, my recovery at home and the three months of follow ups to find out if the ablation was a "success," would make this post look like the first draft of a novel. So…..I'll spare you that.

I would strongly recommend you discuss ALL of these questions with your cardiologist and/or EP. But to learn the basics about the procedure, I suggest you check out some websites (I KNOW….I KNOW! USUALLY THE WORST ADVICE ANYONE CAN GIVE) But………if you go to the RIGHT websites, you will get a great deal of accurate, up to date information about AFIB and the procedure will be explained in detail. I will post a couple of trustworthy websites, but you will also be getting a lot of great answers, and reassurance from many people on THIS site who have undergone ablation and sometimes, more than one. (Don't let THAT scare you!) Next month, on the 20th, will be my one year anniversary of MY ablation and I'm very happy to tell you that from day 3 post surgery to now, I have not had ONE SINGLE EPISODE OF AFIB!!!!! The only medication I am still on is a blood thinner and that's just a given when you have AFIB. (I should have mentioned this earlier, but you need to understand that AFIB is not "curable." It IS highly treatable. Your EP will explain this to you)
Websites:
1) https://www.mayoclinic.org/tests-procedures/atrial-fibrillation-ablation/about/pac-20384969

2) TYPE IN………. cardiac ablation videos mayo clinic

These two sites alone will give you many answers and prompt you to ask your doctor pertinent questions.
Other websites include the Cleveland Clinic and UC Berkley.

If you have further questions, just post them here……we'll be here for you!

RubyWitch

Jump to this post

What problems did you have with the medications?

REPLY
@justkiddingkim6

What problems did you have with the medications?

Jump to this post

My cardiologist feels I have been reasonably controlled on the sotalol, but I am having breakthrough episodes and a heartbeat that is a little slower than he would like.

REPLY
@danab

@rainyday541 Hi i have had quit a few Ablations but my Heart had a much more serious problem. Mine was not Afib and from reading lots of post here on connect Afib seems to do well with ablations. My issue was a fast heartbeat called Vintricular Tacrocardia but the actual process of an ablation starts basically the same. Depending on the EP Doctor he will probably get you set up in the cat lab which requires lots of pads on your body that are used to Map your heart. Then depending on if he wants you awake or asleep will come in prior and decide if you will be in a twilight type awake mode or out completely then they will start mapping your heart to see what electrical paths in your heart puts you into Afib. If he or she is able to see some will then start the ablation portion which requires inserting cathetars in either your groin or sometimes other access ports on the neck or wrist. For me most times i was totally asleep for this part and some of mine took hours. I have had more than i care to remember but all of them went smoothly and i would wake up to usually having to spend 4-6 hours flat on my back while the incisions in my groin started to clot. That's basically the process please ask any questions you may have.

Jump to this post

Thank you for your help!

REPLY
@rubywitch67

Hi rainyday!
First, I've got to say I'm really surprised your cardiologist didn't "talk" you through the procedure. That doctor would have lost major points with me for that oversight. (Perhaps, as a retired RN, my expectations are a bit more demanding)

When you ask "what is the process?" I'm not entirely sure what you mean by that. If you mean how did you arrive at the point your cardiologist recommended an ablation, then the question is fairly easy to answer.

Once a diagnosis of AFIB has been reached, depending on the type and severity, there ARE options. I was not a Cardiac RN, so from this point on, I am speaking ONLY as a patient, diagnosed with paroxysmal AFIB, who underwent an ablation one year ago.

After I received my diagnosis, my cardiologist did a complete work up…..blood work, stress test and an MRI because of my age (68) and other risk factors I had for stroke, which is a major concern for those of us with AFIB.

I was immediately put on blood thinners to lower my stroke risk. Since my AFIB episodes were, at that time, fairly random and stopped on their own, my doctor held off prescribing antiarrhythmics ( a drug that regulates your heart rate).

This regime worked pretty well for about a year, but eventually the episodes of AFIB became more frequent, lasted longer and my heart rate during an episode became much higher. I was put on an antiarrhythmic medication which had unacceptable side effects for me. We tried a different drug with very similar results. It was at this point my cardiologist began talking about an ablation.

He talked to me in great detail about the surgery, the procedure, the possible outcomes and the recovery process. I was definitely nervous, but perhaps not quite as much as most people. NOT because of my medical background, but because I had already had two stents placed in my coronary arteries due to plaque buildup. So, I was at least a little familiar with the laparoscopic procedure, the somewhat scary environment of the cath lab and the recovery procedure which are very similar. (My stents had been placed about 8 years before the AFIB showed up)

When it was decided, between my cardiologist and myself, that antiarrhythmics were not going to work for me, he sent me to see an EP. An EP is a Cardiac Electrophysiologist, a cardiac surgeon who specializes in abnormal heart rhythms. If you think of your heart as an engine, which has to run extremely well, think of your EP as a top notch mechanic!

A few weeks later I had a one hour consultation with the EP my cardiologist recommended. He had all my test results and agreed with my cardiologist (AND ME) that an ablation was the best next step. He discussed the procedure from the moment I walked into the hospital through my discharge the next morning. He answered every question I had……even the ones I had already asked several times. I believe I was incredibly lucky to have an EP who understood how frightening this procedure was to most people and his patience and compassion were outstanding!

To write about the procedure in detail, the hospital recovery period, my recovery at home and the three months of follow ups to find out if the ablation was a "success," would make this post look like the first draft of a novel. So…..I'll spare you that.

I would strongly recommend you discuss ALL of these questions with your cardiologist and/or EP. But to learn the basics about the procedure, I suggest you check out some websites (I KNOW….I KNOW! USUALLY THE WORST ADVICE ANYONE CAN GIVE) But………if you go to the RIGHT websites, you will get a great deal of accurate, up to date information about AFIB and the procedure will be explained in detail. I will post a couple of trustworthy websites, but you will also be getting a lot of great answers, and reassurance from many people on THIS site who have undergone ablation and sometimes, more than one. (Don't let THAT scare you!) Next month, on the 20th, will be my one year anniversary of MY ablation and I'm very happy to tell you that from day 3 post surgery to now, I have not had ONE SINGLE EPISODE OF AFIB!!!!! The only medication I am still on is a blood thinner and that's just a given when you have AFIB. (I should have mentioned this earlier, but you need to understand that AFIB is not "curable." It IS highly treatable. Your EP will explain this to you)
Websites:
1) https://www.mayoclinic.org/tests-procedures/atrial-fibrillation-ablation/about/pac-20384969

2) TYPE IN………. cardiac ablation videos mayo clinic

These two sites alone will give you many answers and prompt you to ask your doctor pertinent questions.
Other websites include the Cleveland Clinic and UC Berkley.

If you have further questions, just post them here……we'll be here for you!

RubyWitch

Jump to this post

You mentioned that your took antiarrhythmics before your procedure, but did you take beta blockers to try and control your afib before?

REPLY

Had ablation a couple of weeks following my first episode of afib. It was performed as day surgery by the electrocardio doc who I really liked, the rascal promptly moved away. There was very little upfront explanation. Went up from groin via femoral artery but I was in lala land before that was performed. The only med I was instructed to take following the procedure was the blood thinner apixaban (aka, Eliquis). This was a significant disappointment as I got the impression the ablation would be free of post-op stuff. Bummer. I was started on 5 mg. 2 x daily, Pleaded with doc to reduce me to 2.5 mg as I was almost 80 at which point the recommended dosage reduces to 2.5. A stickler, he resisted. I complied.
Eliquis is outrageously pricey. By the time I reached 80 I was with a new cardio guy who I also like. He agreed at 80 to drop to 2.5 mg. and agreed to continue to Rx 5 mg and allow me to cut 'em in half for an immediate 50% cost reduction. Even with Medicare coverage it's costly and doubtless prohibitive for some folks.

So far as the procedure itself it was as close to a walk-in-the-park as surgery can be.
BTW, the Eliquis is believed to reduce the likelihood of stroke from 4% to 2%. Big wooo! I talk cocky but I'm still taking the stuff. Good luck, you'll do fine. Don

REPLY

Hi I am about to have my 3rd ablation. Basically you go into hospital they sedate you. Go in through your groin. Map out the faulty pathways in your heart and zap them . You are conscious the whole time. It can take between 2-3 hours. You then go to recovery and then back to the ward. You can get home the same or next day. Usually its a weeks revovery time then back to work. I hope this helps.

REPLY
@jimr

You mentioned that your took antiarrhythmics before your procedure, but did you take beta blockers to try and control your afib before?

Jump to this post

I was taking both atenolol (beta blocker) and amlodipine (calcium channel blocker) for hypertension years before the AFIB appeared. (I also have PVC's which I had most of my life) When the trial of antiarrhythmics "failed," I continued with the amlodipine and atenolol. My atenolol dose was raised from 75mg to 100mg post ablation when the PVC's began recurring, but at a much lower frequency. I would have to say the answer to your question is that the atenolol did NOT "control" the AFIB…..at least at the dose I was on, and my cardiologist and EP never suggested increasing the dose to attempt control. It has been nearly a year since my ablation and I continue to take 5mg amlodipine, 100mg atenolol and 20mg of Xarelto. I have had zero recurrence of AFIB and infrequent PVC's. (Neither of my doctors are concerned about the PVC's)

REPLY

Thank you all for your helpful information. I'm still waiting for an appointment. My cardiologist made a referral, but I am having an echo done and they may be waiting for the results.

REPLY

I think the main point to remember is what a cardiologist told me: everyone is different re how they experience it. I suspect the cause of it may differ too. Mine may have been caused through years of undiagnosed / untreated sleep apnea (I didn't realize I had sleep apnea but when I learned about it, there is no doubt that I had it for years). Sounds like the procedures and drugs differ too. I had 3 ablations – two thru my groin and the third was just below my left shoulder. I have been taking Diltiazem 120 mg and Propafenone 150 mg x 3 daily but I was just taken off of the Diltiazem 6 wks ago since my heart rate was low. I have traditionally had a lower heart rate both in resting and with activity so the Diltiazem had dropped it too low (although I was on it for about 7 years since my last ablation). Re the procedures – I was not awake for any of them. They lasted 5 1/2 hrs to 7 hrs each because they had difficulty getting me into afib while on the table. Adjusting to afib was my biggest challenge only because mine is exercise induced so I had to give up sports like hockey after 45+ years of playing, running and swimming. But one adjusts their lifestyle and moves on. Good luck with your journey.

Liked by rainyday541

REPLY
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