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Dealing with a lot of pain at the puncture site after ablation

Posted by Marg 
Dealing with a lot of pain at the puncture site after ablation
July 08, 2025 03:21PM
Hi All,

I had my first ablation in 2012 with Dr Khaykin in Southlake Hospital in Ontario, Canada. Had no problems healing. I had my second last week on June 30th, also at Southlake, with Dr Pantano. Immediately upon the painkiller wearing off, I noticed a feeling of a cramp or muscle spasm in my leg just around the puncture site. It felt like I should stretch it but the nurse told me not to stretch. When I got out of the car after the drive home I couldn't straighten up or walk properly, the cramp was so bad. Gradually over the last week it felt better and although I always noticed it was there, it wasn't too painful.

Until yesterday, when suddenly, after sitting for a couple of hours, the pain was horrific and I couldn't move without feeling it. I called the nurse and she said to take a painkiller and rest. I tried that - took two extra-strength Tylenols and rested. I don't usually take any painkillers at all, so I expected to feel this dose. But it did not make a dent in the pain. After a few hours the nurse suggested I go to the nearest emergency room.

They suspected a pseudo-aneurysm, and did blood work and an ultrasound. Everything showed normal. When I asked why it should suddenly become so much more painful the ER doctor suggested it was because maybe an aneurysm had started and since stopped. Basically he said go home and take painkillers.

I had never heard of this complication before and am not sure I have been diagnosed properly. It feels as if it is a spasm in the muscle going through or past the puncture site.

Has anyone else had this? Does it eventually go away? I am in pain every time I move. Lying down is not as bad as it was yesterday but any movement, particularly moving from standing to sitting or vise-versa is extremely painful. Lifting my right leg is not easy and results in pain. Going up and downstairs, I have to always lead with my left leg and then drag the right behind me.

Any insight is welcome. Thank you.

Marg
Re: Dealing with a lot of pain at the puncture site after ablation
July 09, 2025 01:32PM
Update: Doctor Pantano thinks it was a nerve that got touched during the ablation, and it caused the muscle to go into spasm.
Re: Dealing with a lot of pain at the puncture site after ablation
July 09, 2025 03:02PM
I was suggested to use two fingers per site and apply pressure when standing or when sitting. I found that helped.
Re: Dealing with a lot of pain at the puncture site after ablation
July 09, 2025 05:27PM
Thanks for the suggestion. The pain was actually coming from a muscle in spasm as opposed to the hematoma. I did try the pressure but it did not affect the pain.
Re: Dealing with a lot of pain at the puncture site after ablation
July 09, 2025 06:43PM
As you seem to have figured out, it's probably a hematoma that's pressing on the femoral nerve. I experienced that after I had the insertion site bleed following a cardioversion. It was quite painful and it took about a month to calm down. Lucky for me, this was back in the day when doctors were willing to prescribe real pain relief.
Re: Dealing with a lot of pain at the puncture site after ablation
July 12, 2025 02:27AM
Thanks for your reply, Carey. Yes, that is what I think has happened. It seems to be settling now, still painful to walk and I can't lift my leg easily, but it is better than three days ago.

Now I notice I have about seven little scabs from the punctures. I am assuming they may have had trouble finding the vein and had to make a few tries? I assume this is also the cause of the amount of bruising I have and the nerve injury.

The bruising that was around the puncture site has now migrated to further down my leg and to the back. I don't know how normal this is. With my last ablation there was very little bruising. If anyone has any experience with this, I would appreciate hearing.
Re: Dealing with a lot of pain at the puncture site after ablation
July 12, 2025 02:45AM
That bruising drifting down your leg is perfectly normal. Gravity always wins. I have a picture of mine with black and blue running all the way down my upper thigh to my knee. It will take a couple of months go go away, but it will. It's harmless.
Re: Dealing with a lot of pain at the puncture site after ablation
July 12, 2025 02:48AM
Thanks, Carey, that puts my mind at rest.
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