Considering an Ablation to Treat Your Atrial Fibrillation? Read This First!
I had a catheter ablation on March 5, 2015. As of the time of this writing, I've been AFib-free for over a year and a half. Having the ablation was the smartest thing I did to treat my atrial fibrillation.
When my AFib started spiraling out of control, as it is known to do, I immediately scheduled an ablation. I didn't even want to try drugs as I was concerned about AFib medication side effects and I didn't want to be on them for the rest of my life.
I was blessed to have a very smooth and uneventful ablation and recovery. In this article I’m going to share with you what to expect if you're having an ablation and some tips on how to make the whole process as smooth and successful as possible.
If you want to read about my ablation experience, I encourage you to read my blog post about it here. I also documented my entire three-month recovery process.
Without further ado, let's get started!
There's probably nothing more nerve-racking than waiting for a heart procedure. Once you make up your mind to have an ablation and schedule the procedure, your mind is going to play all kinds of tricks on you. And you'll most certainly have second thoughts at some point leading up to the procedure for fear of the unknown.
My goal is to provide a list of realistic expectations to put your mind at ease. To that end, here is what you can expect. I hope it makes you feel more confident about your decision to have an ablation and quells your fears!
The Catheter Ablation: What to Expect
First of all, you're not going to die! Ablations are such a common procedure these days that you have a better chance of dying in a car accident than dying from an ablation.
Yes, it's technically heart surgery but even the most inexperienced EPs are able to safely do ablations these days.
Before the Procedure
Go into your ablation expecting at least two procedures and possibly even three if you are a difficult case. If you're a one and done case, that's icing on the cake and consider it a blessing — but it's not the norm.
Always seek the most experienced EP you can find. I traveled across the country (Minnesota to Texas) to have one of the best EPs in the world do my ablation.
The success of your procedure will be totally determined by the experience of the EP (and the complexity of your case).
You'll be on a blood thinner for a short period of time leading up to the ablation and after, but don't worry about it. It's no big deal.
You're not going to bleed out and it's very unlikely you'll experience any adverse side effects from them.
During the Ablation
You'll most likely be asleep during the entire procedure so you won't feel a thing! I say "most likely" because some centers will have you heavily sedated but still partially awake during your procedure.
Either way, you will not experience pain or any discomfort during the actual procedure and you won't remember anything afterwards.
You'll most likely have a urinary catheter. Some say it's no big deal while others say it is extremely painful having it removed.
If it is painful, it's short-lived (literally seconds) and will likely be the most painful thing you'll experience during the entire procedure. I was very fortunate and didn't have one!
Immediately Following the Procedure
You'll most likely have to spend at least one night in the hospital and you'll be on your feet and walking out the door the next morning! Some centers will let you leave the day of your procedure, but the vast majority of centers will keep you overnight.
The dreaded six hours of lying on your back after your procedure will not be bad at all. You'll be too tired to want to move anyway.
I was really nervous about this one, but it's not what you think. I was under the impression you had to lie there like a corpse just staring at the ceiling for six hours. It's not like that at all.
You simply lie in your bed like normal. You just can't turn on your side or stomach or bend over. Imagine lying in your own bed watching TV for six hours. That's all it is.
You may have bruises around the catheter punctures in your groin area. They may be sore for a day or two, but nothing you can't handle. Then again, you may not have any bruises or soreness, which was the case for me.
The Catheter Ablation: What to Expect
Ablation Recovery
Everyone is different, so how you recover will vary. When I had my ablation, the next day I felt so good that I went out to eat with my wife and kids. I felt totally fine.
On the other hand, I've heard from others who were laid up for a few days after the ablation and didn't start feeling normal until a good week after.
You may experience possible annoying (but minor) aches and pains. You may have a dry or sore throat. Your chest might feel tight or have a burning sensation. You might feel achy.
All of this is temporary. By the next day most of these aches and pains will be history.
The goal of an ablation is to put you in permanent NSR without any drugs. However, you may still need to take drugs to keep you in NSR during the three-month recovery period known as the blanking period. Don’t get discouraged by that — it's part of the process. Needing to take drugs is not an indication your ablation was a failure! In most cases you will be able to come off your drugs after the blanking period.
You hope to be done with any arrhythmia after your ablation, but you may experience atrial flutter that may require a cardioversion.
Atrial flutter after an ablation is common. Experiencing it and needing a cardioversion is not an indication that the ablation was a failure!
Tips to Ensure a Sound Mind and Body
Now that we've got the expectations out of the way, I'd like to share some tips with you that will help you mentally and physically prepare for your ablation.
Stay Optimistic
Ignore all those depressing statistics that show how ineffective ablations are. Those statistics take into account ablations done for all types of AFib cases — from easy cases to very complex cases — done by all skill levels of EPs.
Despite this, the success rates for ablations still aren't that bad — about 60-70 percent after one procedure and 80-90 percent after two procedures.
As I mentioned earlier, the EP doing your ablation and the complexity of your case will determine your success rate. If you have paroxysmal AFib and you've only had it for a year and a highly qualified EP is treating you, you'll very likely be in the 90 percent success rate after one procedure!
On the other hand, if you've had persistent AFib for many years and you go to an EP that has only done 100 or so in their career, you can almost be assured you'll need two procedures or more.
Age Isn’t Everything
You're not too old to have an ablation! An experienced EP can do successful ablations for people even in their 80s and 90s.
If you're in your 60s or 70s and your EP is telling you you're too old for an ablation, look for another EP immediately!
Keep Your Body in Check
If you're overweight, lose weight! Being lean helps the EP do their job better and will help you recover faster with fewer complications.
Don’t wait for your AFib to get worse before having an ablation. You may only be experiencing an AFib episode once every few months now but it almost always gets worse over time. And when it does, it becomes harder to ablate (i.e. your odds of needing two procedures increases significantly).
Confidence Is Key
Once you've made the decision to have an ablation, don't look back or second-guess yourself. Be confident you made the right decision.
Don't back out even if your AFib suddenly goes silent in the days and weeks leading up to your ablation. Oddly enough, your AFib will often go silent after you set a date for your ablation. Don't let it fool you. The day you call to cancel your procedure your AFib will come roaring back.
Once you've set a date for your ablation, stop browsing the Internet to read about ablations. The majority of the ablation stories out there are doom and gloom and depressing. They will only bring you down and have you second-guessing your decision.
Have a positive and confident frame of mind heading into your ablation! Being negative or unsure of what you're doing will not help. Be excited that you will soon be AFib-free!