Ablation Experience

I am writing this for two purposes - First, give those thinking of an ablation a little insight into the process/experience and second, to log this for myself.

Some notes up front:

* I am a big baby when it comes to medical stuff

* I stressed big time for years just considering an ablation

* Date of first ever afib experience complete with a resting heart rate over 200 - admitted to hospital: 12/3/2008

* Date of ablation: 12/3/2018 (ten years to the day of first afib)


So, as I said I had actually been considering an ablation for years with the Cleveland Clinic being my top choice. However, every time I completed the paperwork to move things forward something would happen in my life that kept me from actually going through with it. Earlier this year a family friend told my mother-in-law about his experience with an ablation and he was extremely happy with the experience and results. He recommended Penn medicine in Philly and Dr. D'Souza in particular. With such a glowing review I decided to make an appointment to meet with Dr. D'Souza back in September. I asked tons of questions and felt comfortable with him and he was extremely positive in his outlook and expectations. He didn't push me to set up a date for the procedure, rather he just told me his staff would contact me within a few days to see what I was thinking. That was a good approach because if he would have been pushy I would have left and never looked back.


After a few back and forth scheduling emails we finally decided on December 3rd (10 year afib anniversary). As soon as the date was "on the books" I got nervous. I was also nervous about starting blood thinners but it all went very well. During the waiting period I had an EKG, echo stress test, blood work, the infamous turning 50 test, etc. through my regular doctors/cardiologist in central PA and all was good. So, I had no excuses, no barriers and the time just flew by - before I knew it there were only a few days left before the procedure - and then the nerves hit again because I had to stop taking my flecainide - a med that had been in my system for nearly 10 years. I was worried my heart would go crazy and I wouldn't be able to handle it. Just like every thing else though, it was fine. I didn't go into afib until the morning I showed up in the hospital. I couldn't even feel it at first, which is really unusual for me. By the way, they tell you no food or drink after midnight, which was no problem as my nerves left me with zero appetite.

Arrival - I was called a few days before and given instructions for my arrival and everything went very smooth. Walked in, was registered within minutes and sent to cardiac patient arrival. They immediately put me in a room and started the process. Get into gown - hate those things, got an IV in my left hand, which hurt for a while, and then told I was actually second in the queue - that was at 8:20 AM. To make a long story short - they had just made a major systems change on Friday and it was not going well at all. They didn't come and get me until 1:45.


The procedure - they wheeled me into the prep room where they had me remove my underwear from underneath the gown, they shaved parts of my back, chest and groin. If you have any reservations about everybody and their cousin seeing you naked you will need to get over that really fast. To them you are a body and it is just business. I could really feel my heart freaking out at this point. I laid there for almost another 45 minutes listening to the hustle and bustle of all the doctors, nurses, etc. Almost all of the conversations were people complaining about the new system. One exchange in particular actually made me laugh a little. Nurse asks doctor, "do you think you can do one more procedure today?" to which the doctor replied, "I could do ten more! I just can't do the %^&* reports!" They finally came to wheel me back to the operating room. Let me describe it for you: It was not a small room but it was absolutely packed with stuff. They had brought me in and pushed me up next to the actual table where they would perform the surgery. It had so much stuff laying on it that I didn't know how they were planning to get me on there. There were a few monitors with one of them looking like a huge 60" flat screen. I think someone might have told me that is the one that they look at the 3d mapping of my heart. That was to the left of the table - I was still laying on the other bed to the right. There were people everywhere and a couple of them were behind a sort of glass cubicle at the end of the room - command central maybe? They had music playing - 80s I believe, which was cool with me. Finally they told me they were going to move me to the other table and that I was to remain sitting so they could start putting all kinds of electrical patches on my back. Then they asked me to lay back and put a bunch more on my chest, stomach, legs. Remember, all this is going on and I've had zero meds to even calm me a little - me! Then I heard them saying my heart rate was in the 140s to 150 and I was in full blown afib. Also heard the anesthesiologist saying something wasn't working right - not comforting. People were talking to me on and off the whole time. They put foam wedges under my neck and knees and then one guy put loose restraints on my wrists just so I didn't wake up confused after the procedure and start ripping stuff off/out. I am somewhat claustrophobic so I was thinking this would really freak me out but strangely it didn't too much. Somebody noticed I was a bit nervous and said they were going to give me some meds to relax me - they did and I did relax. Next up...they explained that they were going to give me oxygen and then slowly put me out. I remember the oxygen and then I was out.


Waking up - the next thing I remember is someone in the distance (not really but it seemed that way) tell me to take a deep breath, which I did and then they repeated the request a few more times. I think I was in and out for quite a while after that as I have brief memories of people around me talking, wrapping things up, talking about going home for the night and what their plans were, etc. Then I remember them wheeling me somewhere again. I remember seeing (more hearing) my wife and mother-in-law greet me and then I was out for a while again. Then I started to wake up for real and slowly started realizing where I was, why I was there and that the Eagles/Redskins pre-game show was on!


Recovery - I didn't feel too bad waking up as I was still feeling the effects of the drugs, sedation, anesthesia, etc. I was however at one of the points that I had dreaded almost more than any other - you have to stay on your back for at least 4 hours after the procedure and for me, that is an eternity and I have some sort of claustrophobia about that too. Again, it didn't bother me much at all - I was really surprised. They had a little trouble getting my left groin to stop bleeding - they use two places in each groin to access your veins. They got me up to walk around at about 9pm and walking actually felt a little funny at first. Still felt good to be upright and moving though. The night nurse was a young lady that had only been a nurse for a few months - she finally called in the chief nurse at around 2:30 am I was happy as she said the bleeding was slight and it was really no big deal. She showed the young nurse how to dress it with pressure and said it would absolutely be fine by morning. She was right! Dr. D'Souza showed up kinda early and told me that all went well. He burned over 100 spots around the two sets of pulmonary veins in my left atrium and afterward could not induce any additional afib, flutter, etc. He did tell me that to expect my heart to be pissed at the two of us and that it will make some noise for a while. He also said that all I needed before leaving was to have an echo to make sure everything was ok. He said the echo usually shows up around 11 or 12 - he was wrong, it showed up at 9! I was excited that I would be getting out early...and then the hours just started rolling by with no word on my echo. Was there something wrong? No, it was just that nobody had read it because their system went down!!! For whatever reason that made me come unglued a little - I started getting very anxious - I just wanted to leave. My bp nd heart rate went up and I was starting to get upset. FINALLY around 2:30 they let me go. The waiting both days made this whole experience much worse than what it could have been. I feel like if their system was on track for a few months my stay would have been better. Anyway, I had not mentioned that they told me I may have some mild chest pain from the procedure, especially when taking a deep breath. Not sure I would call it mild - maybe moderate would be a better word (probably from the two cardioversions they did during the procedure). Deep breaths were difficult and the pain continued through late Wednesday. My heart seemed fairly solid though. And all you get to take for the pain is Tylenol, which basically does nothing for me. I did almost nothing for a few days. By Thursday morning the chest pain was pretty much gone but I was in for a bit of a struggle later that day... Happy that the pain was finally fading I was a little more upbeat - we ordered pizza for the night and I was really hungry as I had eaten very little since Sunday. Well, after eating I went upstairs and my heart started acting up. It got pretty bad and at one point I was thinking about calling the doctor. I was having some serious anxiety thinking about all the possibilities if my heart would not calm down. Well, I took a chill-pill and things calmed down somewhat by late that night and I went to sleep. Since then my heart has been very steady with only a few little skips here and there. It is late Sunday night so that is three entire days with everything going very well.


So, there it is - my story to date. I hope this helps anyone looking to have an ablation to better understand what is going to happen and what you may experience physically. I would discount the issues the hospital was having with their new system - that should not be your experience.


Let me know if you have any questions.

Jon



Edited 1 time(s). Last edit at 12/12/2018 03:23AM by Jons.

Thanks for the story!
Procedures are about the same everywhere, but the way we live those events may reveal big differences from one patient to another. We're all so different!

I agree! That is why I wanted to be very up front that I am extra nervous and a big baby when it comes to this stuff. Others that are more chill would probably coast right through it. Still, I am hoping the general description of events, equipment, sights and sounds would be a help to those wondering what to expect.

Jon

One thing that is clearly apparent here is that we all have different experiences with afib. My ablation experience was simple - put under immediately as I entered the operating room. Whatever prep, shaving, etc. was done while I was under. All I remember is starting to count down from 10. Recovery was easy with no pain with just an overnight in the hospital. Lots of bruising at both femoral entry points on both legs, but no discomfort. Back to work two days after the ablation. So far, 12 years afib free except for three short breakthroughs.

Very interesting, Jon. Very different from Bordeaux. For example, they only have one point of entry for the catheter - in the right groin.

I had three points of entry, both legs/groin and one neck.

Wow Ken - your neck? I wouldn't have liked that!!

What ever technique gives the abolitionist the best outcome - why not? I didn't know it until after it was over, but I would have agreed to it if it had been explained before hand. Actually, it probably was explained beforehand, but that was 12 years ago, so my recollection is a bit fuzzy.

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Sam
Very interesting, Jon. Very different from Bordeaux. For example, they only have one point of entry for the catheter - in the right groin.

For my two first procedures, in Brussel, sheaths were introduced in both groins, under general anesthesia.
The third and fourth procedures were done in Brugge, under conscious sedation. Three sheaths in the right groin. The EP there is connected with the team at Bordeaux.
I'm now 2 weeks passed this 4th ablation. More about that in the near future...

That is a lot of ablations...

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Jons
That is a lot of ablations...

I've got Pompon beat.

There are things I should have known two years ago, but being natively French speaking, I hadn't yet found the marvelous community here on afibbers.org.
Had I only known that the right EP is rarely the guy next door, I'd likely had had a couple less ablation procedures.

Pompon, I hope your 4th is the one that brings you relief and healing!!

I hope too ! Thanks for your kind words.

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Pompon
Had I only known that the right EP is rarely the guy next door, I'd likely had had a couple less ablation procedures.

Same here. We seem to have gone down similar paths.

Jon,
Thank you taking the time to write that up.
Very helpful to those of who have never had an ablation.

Tibbar