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In order to allay any anxiety you may have regarding your catheter ablation, we’d like to familiarize you with the process. Following is a breakdown of what will happen at every stage.
What You Should Know Before the Procedure
- Don’t eat or drink anything starting at midnight before the test
Tell us about all medicines you take, including over-the-counter medicines, herbs and vitamins. We may ask you not to take them before catheter ablation, but you shouldn’t stop taking your medicine until we ask you to
- If you take blood thinners like warfarin or coumadin, don’t stop taking them unless you are instructed to do so
- Have someone drive you to your appointment and bring you home
- If you usually wear a hearing aid, wear it during your procedure. If you wear glasses, bring them to your appointment
What You Should Know the Day of the Procedure
These studies and procedures are performed at The Valley Hospital and take place in a room called an electrophysiology (EP) laboratory with specialized equipment.
In preparation for the procedure:
- Your nurse will put an intravenous (IV) line in your arm for medication administration
- Your nurse will clean and shave the groin areas where the venous access will be obtained for catheters (wires) insertion
During the procedure:
- You’ll be given medication through the vein to make you comfortable and sleepy, usually under the supervision of an anesthesia specialist, and local anesthetic to make the groin area numb. After that, we will access the veins, through which we will guide several specialized electrophysiology catheters to different positions in your heart.
- This process is guided by fluoroscopy (a video X-ray).
- With these catheters, we can deliver small electric pulses to pace the heart and sense its electrical activity in order to evaluate the integrity of its electrical system or to reproduce arrhythmias and perform an electrophysiology study.
- Once the type and location of your arrhythmia is identified using specialized mapping systems, the ablation will be performed using either radiofrequency waves or cryoenergy through a specialized catheter to create a scar.
- This scar will either destroy the cells responsible for arrhythmia or form a barrier that prevents electrical impulses from forming a circuit.
- At the end of the procedure, we’ll remove the catheters and put pressure at the site of the insertion to stop the bleeding. Your body forms a plug that stops the bleeding from the puncture sites in 10-15 min, but it takes 3-4 hours for it to become strong enough to prevent bleeding when you move.
After the procedure:
You’ll be moved to a recovery room where you will rest for 3-4 hours.
- You’ll be lying down and should not move or bend your legs for 3-4 hours to prevent groin bleeding.
- Your nurse will check on you often to see if there is bleeding or swelling at the puncture sites.
- After the sedative wears off, we will talk to you about your ablation results and review your home care regimen.
- You will be kept in the hospital overnight so we can observe your condition.
What You Should Know When You go Home
- Follow the instructions we gave you, including taking any new medicines.
- We ask you to take it easy for 3-4 days, including no driving, exercising or lifting weights (walking and climbing stairs is fine,) then gradually increase activity. Most people can resume their normal routine within a week.
- You may have mild soreness initially, and it’s normal to develop a small bruise at the puncture site as well.
- We would want to be informed about any excessive chest pain or shortness of breath, dizziness, syncope or pre-syncope, fever, chills, swelling or bleeding at the puncture site, or swallowing problems.
- We might provide you with a monitor to wear at home to evaluate the results of the ablation.
Even though we’ll have talked to you about your ablation results during the hospital stay, we usually also ask you to make an appointment to discuss the results of your ablation and outpatient monitoring results in greater detail at a later date. At that appointment, you’ll get a chance to discuss your treatment plan moving forward.