My first ablation trip report

I arrived at Mass General Hospital early for my 12 noon appointment on Tuesday the 30th, but Dr. Mansour’s first ablation of the day was running long I was told. I finally got into the procedure room at 3pm and the nurses got me situated on the operating table. I had a little glitch with my INR level. For the whole 6 week period I was over the required 2.0 but my last test last Friday was only 1.7 and Tuesday it was down to 1.3.

That meant they had to put that tube down my throat to check for clots but I was out for that so it was a non issue as far as I was concerned. I woke up 6 hours later and the nurses were putting heavy pressure on the places in my groins where they put the catheters. I was told later that they had 4 different catheters, some to ablate, the others to map.

I don’t remember much about the post ablation as I was pretty much out. I do remember they had a neat hoisting machine to lift me from the stretcher to the hospital bed. I was laying on a sling like blanket that they hooked to a cable then hoisted me up and then swung me over to the bed. But I’m a big guy, about 250 lbs so I don’t know if they use this on everybody. I got to my room at 11:00 pm and was told I had 4 more hours of laying flat.

I’ve read a lot of posts on this site and other sites about how bad laying on your back for 6 hours was going to be so bad but I was quite comfortable and didn’t mind it too much. I had actually been practicing laying on my back when I went to bed the last few weeks, just trying to lay there until I fell asleep. I think this actually helped.

I got very little sleep. The nurses were doing this and that all night long and the floor I was on was quite noisy with all the bells and whistles of all the machines. But I’m an early riser anyway and 5 pm was there before I knew it and when the sun rose I had a picture perfect view of the Charles River Esplanade and Cambridge beyond.

Tuesday morning they weighed me again. I first got weighed when I got there and was 251.5 and now all of a sudden I’m 258.8 and haven’t had a single thing to eat or drink. I was told they pump your veins with saline solution during the procedure and I was retaining a lot of it. I had a catheter and felt like I was going constantly, a very strange sensation but apparently wasn’t voiding enough. They put me on lasix and also hepparin.

The next thing was to have my throat scoped again to be sure they didn’t burn the esophagus. Only this time I was very awake during the whole procedure and except for almost gagging it wasn't bad (on a scale from 1 to 10 with 10 being the worst, about a 2). They also checked my stomach and the nurse showed me a picture of it in recovery and I asked him if I could post it on my facebook page and he said the hospital had to give it to me if I requested it and then I could do whatever I wanted with it. Not sure if he was just playing along with me so I told him I was kidding but would post one of the inside of my heart if they had one. He must of thought I was a nut because that was pretty much the end of our conversation, lol.

Then back to the room and they kept me a little longer than usual because they took another blood sample to check my INR so they could determine my discharge orders. It was still low so they gave me the dreaded lovanox shot and told me I had to give myself these shots until my INR was 2. The nurse gave me a half dose shot so that I could give myself the other shot so she could teach me to do it. Was really a piece of cake as the needle is very fine and goes in very easily.

Also got a prescription for prilosec because they don’t want any acid reflux going up to the sensitive esophogus. I have absolutely no pain and am just a little tired. I don’t know if they are just better at this at MGH or if I lucked out but this wasn’t bad at all.

I am still in perfect sinus rhythm with no extra beats but my Doctor said we won’t know for sure if it worked for 2 months. But if I need a 2nd one, I will do it in a heart beat (pun intended).

I was there 10 days ago with one of Moussa Mansour's colleagues. I also have had a positive experience at MGH except I was under GA and they damaged my uretha a bit with the Foley catheter so was in 36 hours from start to finish (all ok in the end except they still want me to get a cytoscopy just for yuks). I had a bad next day with slow AF every time I lay down but that went away and I may have had a dozen missed beats I am aware of.

Thanks for the report. I'm scheduled for ablation on Dec. 12. I was curious as to why they checked your esophagus. My EP didn't mention this possibility, and it sort of concerns me. I can't figure out why they were in the vicinity of your esophagus in the first place. I've heard about fistulas being a possibility. Is that what might have happened? I will have my INR tested a week ahead of my procedure. Let's hope it stays over 2. Are you taking an anti-arrythmic post-ablation?

The esophagus is right next to the atrial wall- they measure the temperature so as not to hurt it while ablating (at least that is how it was explained to me).

[www.innovationsincrm.com]



Edited 1 time(s). Last edit at 11/01/2012 09:37AM by afhound99.

The esophogus is right up against the heart. They put a temperature probe down your throat during the procedure so they know if they are getting it so hot that it could do damage. They checked it post op as a precaution. If they did do some damage I would have been put on a very restricted diet until it fully healed but it was good and I have no restrictions.

Mary I forgot to answer your 2nd question. I'm on the Tikosyn that I was on pre abaltion. If all goes well I will be able to get off of it after about 2 months since it takes that long to know if it was a success.

I too will be on Tikosyn and will stay in the hospital for three days after the ablation to get the dosage right. I had been on Tikosyn all last year and most of this year and prefer it to amioderone.

MichaelS,
Thank you for sharing. My ablation is scheduled for February, it is encouraging to hear that all went well.

Mary Wrote:
-------------------------------------------------------
> I too will be on Tikosyn and will stay in the
> hospital for three days after the ablation to get
> the dosage right. I had been on Tikosyn all last
> year and most of this year and prefer it to
> amioderone.


If you already have done the 3 day hospital stay to get the Tikosyn dosage correct I don't see why you have to repeat that. I was on Tikosyn until just before the procedure (they had me get off 5 days prior), then after the procedure restarted me on the same dose. In any event good luck and have a positive attitude.

TIKOSYN users:

I am also on TIKOSYN 500mg b.i.d.; I would have preferred ablation straight away but my left atrium was (is) enlarged. With TIKOSYN and NSR it has shrunk from 60mm to 55mm. and will find out if it has shrunk any more next week I think. They are looking for something below 50mm for greater success rate and 40ish mm for greatest success rate.

I would ask you if your left atrium expanded while in aFib and if TIKOSYN made any difference for you and to what extent.

I have been on TIKOSYN since December 2011 and find that I am awakening early in the mornings with slight nausea and a very "thick" head that takes up to two hours to clear and let me get out and do some part-time work. With two in University (Engineering and pre-med Kineseology/Anatomy) we are going slowly broke here.

Murray L

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Tikosyn uptake Dec 2011 500ug b.i.d. NSR since!
Herein lies opinion, not professional advice, which all are well advised to seek.