Information for ventricular tachycardia ablation

I was not treated for VTach, but was treated for atrial fibrillation (AFib, or just AF). However, both treatments using radio frequency catheter ablation involved insertion of a thin catheter into a vein, whether the femoral, radial, or carotid (thigh, arm, or neck). The catheter is forced through the septum to the left atrium or ventricle, or into the AV node or SA node as required for different procedure, and the are is burned with radio intensity. Not radioactive, just something like microwaves. The idea is to create burns, lesions, which will ultimately heal over as fibrosis or scar tissue. The undesirable electrical impulses causing the multiple beats or rapid beats cannot transmit across the 'dam' of scar tissue, and with that, the arrhythmia or rate problem should cease. Again, my experience is not with rate control but with rhythm problems. And beyond that, I am out of my depth.

There should be no heartburn with reasonably care by the team and by you and your daughter if you follow prescribed practices and medications. It might be that the surgeon will want an endoscope inserted in your daughter's throat. This happens after she loses consciousness so she doesn't freak out. The particular procedure is a TEE or trans-esophageal echocardiogram. They use images from the endoscope to determine where her esophagus is (in relation and proximity to the heart itself) and if/when the radio catheter gets so close that it might result in burns. At least, that was my experience, and I'm guessing it will be much the same thing. Your daughter will probably be prescribed sucralfate, a chalky, sickly sweet, white syrup to take an hour before each meal, and perhaps pantaloc as well. Again, and I hate to repeat, I can only relate what I went through and the reasoning behind it. It may be different for your daughter's procedure. Otherwise, I don't know why heartburn should sometimes be an issue. This is a question to get settled prior to the procedure, but absolutely prior to her being discharged.

Pain ? Not normally, just some tightness in the chest possibly, or a sore throat if the TEE was withdrawn quickly and her throat had gotten dry. I had a very sore throat, and mentioned it. prior to a second ablation procedure seven months later (my first ablation wasn't complete, so I needed a second...long story). The helpful anesthetist was glad to hear me speak up, and said he'd take care of it. And he did.

However, some patients do get pericarditis after catheter ablations, and I see descriptions on forums where it is discussed (not so much here) that it is most unpleasant. It is temporary, and treatable.

If you have other questions, I'll try to answer them as best I can. I think a big help is to keep in the back of both your minds that it's considered out-patient care, and that you'll both be home by about 2000 hrs at the latest that same day, assuming nothing happens or that you live a couple of hours away from the hospital.

Hi @tmenfenh4, Im a former VT person and I've had about 8 Ablations during my years with VT. Unlike the prior person with AFIB, VT is in the lower part of the heart and the esophagus was not even a problem with the Ventricles or lower part of the heart. But it is true the ablation mechanics are very similar. All of mine were approached from the lower artery location near the groin. All done while She is asleep. Prior to putting Her out they will probably do what is called a mapping. They place large pads on her chest and back and with a type of xray they will try to see which paths are causing the arrythmias. The other parts are similar. Either with radio burning or I've heard of using cryo which is freezing. All of this is done inside the heart lower ventricles. So when they get Her permission it will probably be the mapping first and if they see something that needs ablating, they will get permission to proceed with that phase which is usually under general anesthesia. It can be a rather lengthy process since the goal is to not be able to cause her heart to go into an arrythmia. mine ranged from 3- 5 hours If successful that's great but its possible that they may not get them all the first try. I myself from my first one got 90 % better but about a year later my doctor felt a second one was a good idea and he was right I felt completely normal just with some Maintenace meds also.
Now after the ablation the Heart is not very happy I liked to say so the doctor may keep her on anti-arrythmia meds for a while usually about a month and the heart will be fully healed and it will calm down so at first the full benefit may not fully happen until about a month later. But at least with my first ones my arrythmias got a lot better and less often. Now I might mention and if you want to share the reason my problem happen was due to a enlarged heart due to fluid retention around the heart. This happen due to a really bad flu bug that caused fluid retention in the sac around the heart and lungs. My heart never fully recovered from that problem of the enlargement and towards the end of my 10 year bout with this we elected on a heart transplant. I wanted to mention that mainly because your daughter's reason for the arrythmias May not be as severe as mine, so please don't think she may require lots of them. But also after my second one i was living completely normal life, very active and it's just that my heart lasted about 10 years before we had to try the other 6 ablations over the last 2 years prior to transplant. So Im 65 and I had my first issues at 49 so just know that there are many options and her being much younger than I will mean a lot better healing and recovery. She may have just this one and have a great outcome. Please know, Like I said, I've been thru about 8 I lose track and have a wide range of experience so ask any question you want. Oh as for pain the incision site where the catheter goes in will heal in a few days and the most painful part was when I had to remove the dressing a few days later. I always did it in the shower as having the water run over the area helped a lot. And if its done in the groin area she will have to lay very flat for about 3-6 hours depending on the type of catheter. after about 2-3 hours they will sometimes raise the bed up a bit and I always looked forward to the nice sandwich about that time. remember its surgery so by then it would typically have been about 12-15 hours since she last ate. If the neck option is suggested the recovery is typically shorter. I had the neck type during my post-transplant biopsy's. They take a sample of the transplanted heart to see if its rejecting. So I have experience with that also just not during an ablation. So Im here for any questions you may have. Take care and please let us know how it goes.

She has a qtr prolongation. It's hard to explain. She was born with it. I'm worried she will have to have more then one ablation. As far as the medication for heartburn. I'm worried. She is allergic to sulfates. So what can she do for heartburn. I know most of my questions are probably for the doctor, but want to be prepared. So the pain ,will it be for a Day or days? Just worried. She is only 24. Her life has been so tough. She has a defibrillator at the age of 15. I kinda understand the process so thank you. Just wondering about recovery. We are not close to home. So staying at an air nb. Are there restrictions after procedure?

I had a catheter ablation a few years ago for supraventricular tachycardia. Different part of the heart, but I’m assuming much of the process was the same as what your daughter will experience. They snaked a catheter from my groin up to my heart. It was a piece of cake. I spent one night in the hospital so the entry point in my groin could be monitored and then I was back home. I had to take it easy for a few days but it was successful with minimal discomfort.

As I mentioned above I never had any heart burn. Different part of the heart. The pain was only at the incision site. As for recovery most times I was overnight in the hospital.
Only restrictions was no shower the first night after the procedure but after 24 hours if there is no oozing from the site the dressing will come off.
Thats a good plan to stay near the Hospital but it should only be at most 2 days.
I actually had a Pacemaker with difibulator also. I'm sure that technology has improved quite a bit. With the 2 I had over my 10-year period (battery replacement) the second one had more capability than the first. With the right EP doctor there is a lot that can be done with it also.

I had an ablation this past January at the Cleveland Clinic. I had a PVI ablation Their protocol for me was taking Pantoprazole, a proton pump inhibitor to prevent acid reflux, for 4 weeks after. That worked well for me. I stayed overnight without complications. I had a pacemaker implanted in February. Once again without complications. I’m 76 so I feel these procedures are almost like tonsillectomies were when we were young. Of course I had the utmost confidence in my EP, his team and the hospital.

I had my second ablation this past November. Both it and my first one were for me not bad at all (and I’m a total wimp when it comes to any kind of medical procedure)
I was released the same day both times. I was knocked out so no discomfort during the procedure. Big bruise on my thigh where the catheter went in but no pain. Good Luck!

@tmenfenh4
I have had ablation done. It is done as an outpatient procedure. There is no pain. The normal procedure is through an artery in your groin (some use other areas). You will be numbed in that area and feel nothing but pressure. There is no feeling other than that.

You do have to wait 8 hours with pressure bags on the artery. I am told there is a no procedure where they put a cap or device on the artery used and you do not have the 8 hours of waiting. There will be no pain after the procedure (at least I had none). You do have to be careful with the area like no strenous exercises for awhile and no water sumersion.

I would try to provide assuances it is a procedure done millions of times and done as outpaitent. I actually wanted to do another one to stop LV PVCs but my EP this time wanted to try medications before doing the LV ablation (last time is RV). I would much rather have the ablation that deal with PVCs.

We live 1 hour 30 minutes from the hospital where I had my ablation. I asked to stay overnight because of the distance and my EP agreed. Another reassurance I had was the transmitter they sent home with me. After the ablation there a a 3 month “ blanking “ period where your heart is adjusting , settling down as it were. The transmitter transmits an ekg to help monitor how the heart is working. I sent a routine one once a week and also if I felt I was in a fib, rapid heart beat etc. This was a huge help. My transmissions showed my heart was having pauses. A heart monitor was sent and detected I needed a pacemaker which was implanted one month after my ablation. My blanking period will be over in 2 weeks and I will return the transmitter at my next appointment. Hoping your daughter had a successful procedure.