Two Days Post Ablation

It's been 2 days since my ablation at BIDMC in Boston.
The entire staff were all personal, efficient and professional. Preprocedure, they made certain everyone intoduced themselves and explained their role in the procedure. This was very reassurring. My doctor said everything went very well during the procedure.
One of the nice surprises was that they only inserted one catheter. I was expecting 2 insertion points.
I was released the same afternoon with a 30 day prescription for a PPI. So far, no issues and I'm feeling good.
Looking forward to being AFIB free....

Best of luck for a long life in nsr!

Sounds great! Was this a cryo ablation?

No, I had a RF ablation.

Congratulations!
It’s interesting how some hospitals are releasing the same day and some aren’t. I have an ablation scheduled for December with Dr Hongo in San Francisco and they keep people overnight.



Edited 1 time(s). Last edit at 11/11/2021 01:34PM by Brian_og.

One of the nice surprises was that they only inserted one catheter. I was expecting 2 insertion points.

I think they use more than 1 catheter. They may insert two or three sheats in the same groin or use both groins.

What would determine the choice of one I insertion point over 2?

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Brian_og
What would determine the choice of one I insertion point over 2?

I would assume fewer catheters. For most RF ablations there are four catheters placed in the femoral veins, and each vein can accommodate two catheters. The standard catheters used are for ablating, mapping, ultrasound, and transseptal puncture. Some EPs will also make another insertion site in the neck or shoulder to accommodate an additional device such as an internal BP monitor.

So either they they didn't use all the standard catheters, at least not at the same time, or they found a way to accommodate more than two catheters per vein. I have a hard time seeing how they could give up any of the four, or why they would do so.

Carey, my last ablation report says "three sheaths (1*6;2*8)". They all went through the same groin. Could they use two catheters together in the same sheath? If not and four are used, it's successively...

Professor Jais of Bordeaux uses only one insertion point in the groin. I was kept in for 4 days with regular

monitoring; during the night as well as the day for the first 2 days.

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Pompon
Carey, my last ablation report says "three sheaths (1*6;2*8)". They all went through the same groin. Could they use two catheters together in the same sheath? If not and four are used, it's successively...

I believe a sheath can accommodate 2 catheters, but 3 sheaths in one vein? Wow, that was a crowded vein.

For my PVI and first touch-up, in another hospital and another EP, I had both times left and right groin insertions.
Here, I had only sheaths in the right groin. I was surprised and I asked the EP. I remember he replied it was patient depending. I guess he would have used a second insertion site if needed.
He's Bordeaux trained and still connected with the french team. From Sam's post here above and things I've read here about Bordeaux, I think they have their habits (CS is common use, there) and my EP is in that league.
From what I've read here too, it seems american hospitals are more conservative in their approach.
I believe it's crucial having an EP comfortable with his tools and procedures, with patient's agreement of course.

I have not yet received the ablation report, once received I'll update on why I had only one insertion point (and what was inserted).

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triplea
I have not yet received the ablation report, once received I'll update on why I had only one insertion point (and what was inserted).

Yes, please do. I'd like to see how they manage that.

I talked to my EP a few weeks ago about my upcoming ablation. He mentioned that they found that putting catheters in both side worked out better for the patient. He didn’t elaborate and I didn’t think to ask him why. Would that make any sense to anyone?

OK, I received the procedure notes..."via the right femoral vein one steerable Vizigo transseptal sheath, a 9F (ICE), and 7F sheaths were placed".
Not sure what it means, but maybe I'll get some good questions to ask when I visit my EP in January.

Are you back to feeling normal now after one week?

Yes...feeling fully recovered after a week.