How to convert at home, and Cardio appointment

I was able today to see a Cardiologist for my Paroxysmal Afib, I was pleased with the office visit, and I was impressed he was the one to mention a Rx for the "pill in the pocket". He first wants to do an echo, stress test and Holter monitor before discussing what would be the right Rx for me for "the pill in the pocket". I don't even think I need to go see an Electrophysiologist at this point, I think I may be able to do everything with him. He did not mention about going to see an EP, at least at this first visit.


However, by the time I'm going to do all tests and talk to him again, it will be the beginning of August, and I'm wondering what I could try at home to convert bit faster than the last 3 times, just in case I need to. During the last 3 times in 3 years, I got into Afib with high heart rate. I see people who convert by start running? I do remember in 2 of the 3 occasions, that if I was walking, I would feel better, but not sure I should try to run. What else can I try? any supplement? anything else? what did work for you?



Edited 1 time(s). Last edit at 06/23/2023 07:37PM by Marco.

For some reason, perhaps understandably with the current science, cardiologists seem to want to 'play along' for at least a while. As long as they can prescribe drugs and you go away happy, and stay happy for several months or a few years, it's a win-win for everyone, including the pharma folks. Eventually, though, the majority of people lose ground quickly, often over weeks, and suddenly they can't wait for an appointment with an EP and to get in line for an ablation. Again, quite understandably since being symptomatic with AF is distinctly and almost unmercifully unpleasant.

I hope you understand that, like I was, and as others posting here have been, you almost run out of the cardiologist's offices thinking a few more pills is all you'll ever need. I don't know what the true population average is for those afflicted with AF, but it must be close to 60% will come to learn that the disease is progressive and will begin to act up after a while. The idea is to have an 'in' with an EP and to be ablated as soon as you can be put into the roster once your AF begins to change and to happen more frequently. The idea is to have an 'out' once the symptoms become intrusive, but before they adversely affect your quality of living. As you might guess from what I say, it's a fine line to toe.

In my post to you here, I mentioned vagal, adrenergic and mixed triggers. Exercise most commonly works (IF it works) for those with vagal triggers. Initially, I converted all my episodes with exercise (including running). This lasted for a couple of months, then I had a 2.5 month episode where it didn't work and converted that episode with on-demand flecainide. The length of the 2.5 month episode had me a bit gunshy & I didn't wish to repeat, so converted most of the episodes in the intervening 18+ years with on-demand flec, which I'd take as soon as I knew I was in afib & chew the pills.

I also mentioned in that thread about increased calcium being associated with increased afib frequency as well as many more things that could be triggers. One of those was the time immediately after orgasm. I could feel the ectopy kicking in, and if I immediately sat up or stood up and moved around, I could terminate these episodes instantly. Fortunately, I have an understanding partner! Also fortunately, when I reduced my calcium intake, this trigger went away.

If you think the episode has an adrenergic trigger, vagal maneuvers can terminate in some people. I strongly suggest that you do not try the carotid sinus massage vagal maneuver for safety reasons.

See Jackie's post on avoiding digestive issues, not to terminate but to prevent, if you think digestion could be a trigger.

I did a breathing conversion in March, described here. I'd also taken some flec, but the conversion happened so fast, that in my experience flec never acts that quickly, always takes an hour at minimum.

Another breathhold conversion from a few years ago is described here. This was a bit different than the one above. I started the breathing almost instantly after the episode started and it converted in a few minutes. I happened to be wearing several monitors, so the graphical data are shown in the post.

Before I reduced my on-demand flec dose from 300 mg to 200 mg, I could get some conversions to flutter (which is a very stable rhythm) that I'd then have to convert back to afib (without more meds) to then convert to NSR. On all these I had taken flec and was some hours into the episode. I have tried all manner of things: sitting in a large bathtub of 58 deg F (14.4 C) water for 10 or so minutes (it worked & cold water on face or cold showers can work for some); inverting or standing on my head for many minutes; jumping rope with my breath held out during the exercise; pushups on an exhaled breath hold and so on with other exercises. Sometimes they worked and many times not. I've done Wim Hof breathing( 3 or more rounds of 30-60 hyperventilation breaths followed by long exhaled breath holds followed by an inhaled breath hold of 15 seconds or longer). Interestingly, the conversions, if they happened, were during the inhaled breath hold. It was this realization that had me try the breathing approach in March (above). I commonly wear a recording beat to beat heart rate monitor during my episodes. The displayed heart rate is a moving average, but I can still tell a lot about my rhythm status. For example, I had the chest strap on in the chilly water & watched my afib rate decline and then convert. I have also done meditation or slow breathing and watched my heart rate drop. If I can get it into the 70's, I can usually convert. Almost 100% if I can drop it into the 60's. Some of what I have tried has resulted in heart rates around 225 (like the exercise during exhaled breath holds). I know my afib and my body pretty well, so this does not cause me issues and I can get this rate lower (into say the 130's) without issue. I mention this, as not everything I try may be appropriate for all, so beware! I've also pushed my heart rate to 230 and then had it convert. Again, I'm not saying that any reader should try much of this stuff as there might be negative consequences for other readers. The March breathing approach is tame and was effective that time, which is why I listed it first.



Edited 2 time(s). Last edit at 06/23/2023 09:35PM by GeorgeN.

I don’t know what the true population average is for those afflicted with AF, but it must be close to 60% will come to learn that the disease is progressive and will begin to act up after a while.”

I tried to do some research on this but really didn’t get very far. Maybe others know how. Is there any hard data about the % of aFibers for whom medication ceases to work, impact on their lives, etc. That kind of stuff.

I started with meds for afib. I finally got an ablation after a couple of years. Looking back, I wish I had just started with the ablation. Get an EP. Just my 2 cents worth.

For some reason, perhaps understandably with the current science, cardiologists seem to want to 'play along' for at least a while.

Agree 100%. My situation. First afib in 2017. Seen by the cardio in the ED and I stayed w him as my cardio. Did all the tests. Echo, stress, CT calcium scoring. Subsequently I experienced afib only once a year. Thought the ED was the route go and soon learned to avoid the ED if at all possible. Visits to the cardiologists all the same. He came in, sat across the room. Asked how I was doing? Any episodes? Listen to heart. No change in my meds. I had learned on this forum about supplements such as magnesium. He never discussed any of this w me. When I told him I had read about magnesium and was taking it he said to me “I wish I had thought to tell you that.” He no longer is my cardiologist. Funny when I met w the EP he talked to me about magnesium and wanted to make sure I was taking it.

In 2022 had another episode in summer. Again my episodes were once a year. Then end of September through Thanksgiving episodes were occurring more frequently. end of January the episodes kicked up again. Referred to EP. I had to wait over 2 months to see him. Something you may want to ask about if you need an EP. How long will it take to get an appointment.

The last afib episode was beginning of March. But while the afib decreased the PAC’s increased. They were awful. When I met the EP he gave me options but said the best choice was an ablation. I saw him in January. He was booked through November. I asked around and other EP’s could get me in w a 3 – 4 month wait but I really liked him and wanted him to do the ablation. My PCP had patients he had done ablations on and told me they all were successful. Talking to nurse at cardio office etc all knew him and said they would go to him and had sent family to him. I stayed with the EP. I was told the facility would be opening more dates and had to wait until the end of March before I heard anything about a date. I lucked out. There was a cancellation and the EP staff had me on the cancel list and I had the ablation.

I learned while the episodes were infrequent once a year from 2017 – 2022, it all changed pretty quick. Walking usually helped my episodes. There were nights I was up all-night walking around the house. Sometimes I could not walk because it would raise the BPM and would have to sit. I tried the other tricks such as Valsalva, cold, breathing but walking gave me the best results.
Good luck.

I finally got an ablation after a couple of years. Looking back, I wish I had just started with the ablation. Get an EP. Just my 2 cents worth.
I agree also looking back.



Edited 2 time(s). Last edit at 06/24/2023 10:41AM by JakeS.

wow, this is amazing. Thank you George, I will need to take notes here!

Quote
GeorgeN
In my post to you here, I mentioned vagal, adrenergic and mixed triggers. Exercise most commonly works (IF it works) for those with vagal triggers. Initially, I converted all my episodes with exercise (including running). This lasted for a couple of months, then I had a 2.5 month episode where it didn't work and converted that episode with on-demand flecainide. The length of the 2.5 month episode had me a bit gunshy & I didn't wish to repeat, so converted most of the episodes in the intervening 18+ years with on-demand flec, which I'd take as soon as I knew I was in afib & chew the pills.

I also mentioned in that thread about increased calcium being associated with increased afib frequency as well as many more things that could be triggers. One of those was the time immediately after orgasm. I could feel the ectopy kicking in, and if I immediately sat up or stood up and moved around, I could terminate these episodes instantly. Fortunately, I have an understanding partner! Also fortunately, when I reduced my calcium intake, this trigger went away.

If you think the episode has an adrenergic trigger, vagal maneuvers can terminate in some people. I strongly suggest that you do not try the carotid sinus massage vagal maneuver for safety reasons.

See Jackie's post on avoiding digestive issues, not to terminate but to prevent, if you think digestion could be a trigger.

I did a breathing conversion in March, described here. I'd also taken some flec, but the conversion happened so fast, that in my experience flec never acts that quickly, always takes an hour at minimum.

Another breathhold conversion from a few years ago is described here. This was a bit different than the one above. I started the breathing almost instantly after the episode started and it converted in a few minutes. I happened to be wearing several monitors, so the graphical data are shown in the post.

Before I reduced my on-demand flec dose from 300 mg to 200 mg, I could get some conversions to flutter (which is a very stable rhythm) that I'd then have to convert back to afib (without more meds) to then convert to NSR. On all these I had taken flec and was some hours into the episode. I have tried all manner of things: sitting in a large bathtub of 58 deg F (14.4 C) water for 10 or so minutes (it worked & cold water on face or cold showers can work for some); inverting or standing on my head for many minutes; jumping rope with my breath held out during the exercise; pushups on an exhaled breath hold and so on with other exercises. Sometimes they worked and many times not. I've done Wim Hof breathing( 3 or more rounds of 30-60 hyperventilation breaths followed by long exhaled breath holds followed by an inhaled breath hold of 15 seconds or longer). Interestingly, the conversions, if they happened, were during the inhaled breath hold. It was this realization that had me try the breathing approach in March (above). I commonly wear a recording beat to beat heart rate monitor during my episodes. The displayed heart rate is a moving average, but I can still tell a lot about my rhythm status. For example, I had the chest strap on in the chilly water & watched my afib rate decline and then convert. I have also done meditation or slow breathing and watched my heart rate drop. If I can get it into the 70's, I can usually convert. Almost 100% if I can drop it into the 60's. Some of what I have tried has resulted in heart rates around 225 (like the exercise during exhaled breath holds). I know my afib and my body pretty well, so this does not cause me issues and I can get this rate lower (into say the 130's) without issue. I mention this, as not everything I try may be appropriate for all, so beware! I've also pushed my heart rate to 230 and then had it convert. Again, I'm not saying that any reader should try much of this stuff as there might be negative consequences for other readers. The March breathing approach is tame and was effective that time, which is why I listed it first.

Quote
FibberMcGee
I started with meds for afib. I finally got an ablation after a couple of years. Looking back, I wish I had just started with the ablation. Get an EP. Just my 2 cents worth.

Yes for sure. I have an appt with EP for August 8 already, but the pill in the pocket makes me feel better just in case it happens again, I have something to try until I don't understand what the next step is

Quote
JakeS
For some reason, perhaps understandably with the current science, cardiologists seem to want to 'play along' for at least a while.

Agree 100%. My situation. First afib in 2017. Seen by the cardio in the ED and I stayed w him as my cardio. Did all the tests. Echo, stress, CT calcium scoring. Subsequently I experienced afib only once a year. Thought the ED was the route go and soon learned to avoid the ED if at all possible. Visits to the cardiologists all the same. He came in, sat across the room. Asked how I was doing? Any episodes? Listen to heart. No change in my meds. I had learned on this forum about supplements such as magnesium. He never discussed any of this w me. When I told him I had read about magnesium and was taking it he said to me “I wish I had thought to tell you that.” He no longer is my cardiologist. Funny when I met w the EP he talked to me about magnesium and wanted to make sure I was taking it.

In 2022 had another episode in summer. Again my episodes were once a year. Then end of September through Thanksgiving episodes were occurring more frequently. end of January the episodes kicked up again. Referred to EP. I had to wait over 2 months to see him. Something you may want to ask about if you need an EP. How long will it take to get an appointment.

The last afib episode was beginning of March. But while the afib decreased the PAC’s increased. They were awful. When I met the EP he gave me options but said the best choice was an ablation. I saw him in January. He was booked through November. I asked around and other EP’s could get me in w a 3 – 4 month wait but I really liked him and wanted him to do the ablation. My PCP had patients he had done ablations on and told me they all were successful. Talking to nurse at cardio office etc all knew him and said they would go to him and had sent family to him. I stayed with the EP. I was told the facility would be opening more dates and had to wait until the end of March before I heard anything about a date. I lucked out. There was a cancellation and the EP staff had me on the cancel list and I had the ablation.

I learned while the episodes were infrequent once a year from 2017 – 2022, it all changed pretty quick. Walking usually helped my episodes. There were nights I was up all-night walking around the house. Sometimes I could not walk because it would raise the BPM and would have to sit. I tried the other tricks such as Valsalva, cold, breathing but walking gave me the best results.
Good luck.

I finally got an ablation after a couple of years. Looking back, I wish I had just started with the ablation. Get an EP. Just my 2 cents worth.
I agree also looking back.

Thank you Jackie. I have already a scheduled appointment with the EP for August 8, I guess I was just a bit enthusiastic after the cardiologist appointment yesterday.

If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?

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Marco
If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?

Not exactly. An ablation is burning or freezing a line of tissue around the source of the afib so it's sort of fenced in. The errant electrical signals from that area can't go anywhere to cause afib. It has nothing to do with the shape of the tissue. There's nothing visually different about atrial tissue causing afib and any other atrial tissue.

See an EP.

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Marco
If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?

There is a newcomer, pulse field ablation or PFA. Here is a search on our site.

I'd start with moderator Shannon's posts here. Read Shannon's posts in reverse order (earliest to latest). It will give you a good description of the approach.

Basically it is a different energy source and does not appear to have some of the issues of using heat as an energy source. From my understanding, it is very close to full approval, perhaps in the fall. Reports from members here who have been in the trials and had PFA are positive. Cold is limited as it is used only to ablate the pulmonary veins, which are the starting point in every afib ablation, however, many need to have other areas ablated to solve their afib problem.

If you decide ablation is for you at some point, our general advice is to go to a high volume center with an EP who has done many thousands of afib ablations. Many here travel to Austin TX to see Andrea Natale, clearly a leader in the field.

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GeorgeN

Before I reduced my on-demand flec dose from 300 mg to 200 mg, I could get some conversions to flutter (which is a very stable rhythm) that I'd then have to convert back to afib (without more meds) to then convert to NSR.

George are you saying you now only take 200mg bolus dose flec instead of 300mg? When previously taking the 300mg dose and converting to flutter, how exactly did you convert back from flutter to afib?

Thanks



Edited 1 time(s). Last edit at 06/25/2023 12:02PM by BobsBeat.

Quote
GeorgeN

If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?

There is a newcomer, pulse field ablation or PFA. Here is a search on our site.

I'd start with moderator Shannon's posts here. Read Shannon's posts in reverse order (earliest to latest). It will give you a good description of the approach.

Basically it is a different energy source and does not appear to have some of the issues of using heat as an energy source. From my understanding, it is very close to full approval, perhaps in the fall. Reports from members here who have been in the trials and had PFA are positive. Cold is limited as it is used only to ablate the pulmonary veins, which are the starting point in every afib ablation, however, many need to have other areas ablated to solve their afib problem.

If you decide ablation is for you at some point, our general advice is to go to a high volume center with an EP who has done many thousands of afib ablations. Many here travel to Austin TX to see Andrea Natale, clearly a leader in the field.

As Always, thank you so much for all information

Quote
Carey

If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?

Not exactly. An ablation is burning or freezing a line of tissue around the source of the afib so it's sort of fenced in. The errant electrical signals from that area can't go anywhere to cause afib. It has nothing to do with the shape of the tissue. There's nothing visually different about atrial tissue causing afib and any other atrial tissue.

Thank you Carey. is the area in the atria that doesn't behave properly and cause Afib the same in everyone? if not how is it detected?

Since some research I have done last year, I assume the cause that makes the atria misbehave, it is very different for everyone, if someone ever understand what is the cause, correct?

Quote
BobsBeat
George are you saying you now only take 200 mg bolus dose flec instead of 300 mg?

Yes, it took me many years to figure this out. Right from the beginning of using flec on demand, I'd convert into the 80's (my resting rate is in the 50's or so). It would stay there for a while and later drop to normal. I thought this happened to everyone. Many years into this, one of our members who'd used flec for a long time said that it always converted him to the 60's. Initially, I did not have a Kardia device (got one in 2014) and would use a beat to beat recording heart rate monitor during episodes (Polar strap, initially with Polar S810i watch, later, including today, with an iOS app built for university researchers for recording). A caveat: I've not had a 12 lead ECG during an episode since 2004, hence what I'm calling flutter could just be some kind of tachycardia. However my heart never stays at a high consistent rate, except during afib. Kardia would call the 80's conversion rate NSR. A higher stable rate, say 130's, during an episode, Kardia would call "undermined" or something to that effect. When I first had afib & then started using flec on-demand about 4 months in, I weighed about 205#'s, my college US football playing weight. I was very fit, but not lithe. When I determined I needed to detrain, I started gaining weight, so changed my diet and dropped, over time starting in about 2009 to about 170#'s. I say this as this may have influenced the impact of flec on my system.

In any case, flec started taking longer to convert and would "convert" to a constant rate around 132 BPM. It didn't initially dawn on me that this could be flutter and I would ultimately convert into the 80's and then back to 50's & 60's. The last few years, flec was taking longer to convert and these "flutter" pieces in the overall afib episode became more common. In 2004, I was prescribed branded flec, "Tambocor." Around 2008 I decided to refresh my supply as it was 4 ish years old and Tambocor was no longer sold in the US (it came off patent in 2004). So I started getting branded flec from Europe in blister packs as this would oxidize less. In 2020, I got some generic flec in the US. I only used it in one episode in 2021 and that took me nine hours to convert (very long for me) with many of these "flutter" parts. I initially thought it was because the generic had lower potency than the branded. Then in June, 2022 I had an episode early in the morning. My "fresh" supply of Tambocor was in our bathroom, connected to our bedroom. I decided not to go in and get it and disturb my wife as I had some in the kitchen that had expired in 2014. When I took it, I chewed it as always. I could immediately taste that it had oxidized somewhat and thought that was a stupid mistake as I could not take any more for 24 hours. As it turned out, I converted in ~90 minutes with no "flutter." I also converted to the 60's BPM. Thinking about this, I hypothesized that the expired Tambocor flec had lost 1/3 of its potency. So the next episode, maybe 4 months later (Oct 2022), I tried 200 mg of unexpired Tambocor. It worked as well as the 300 mg of expired med. I've used the 200 mg maybe twice after that. These episodes all converted without the "flutter" in fairly short order. I now hypothesize the generic flec actually had more potency than the Tambocor which is why that conversion was so difficult.

Quote

When previously taking the 300mg dose and converting to flutter, how exactly did you convert back from flutter to afib?

I'd try all the stuff I mentioned in the post above. Nothing worked with certainty. My thought process was to do something to change the homeostasis of the rhythm. Probably the most consistent thing I would do was slow breathing (4-6 breaths per minute with an exhale twice as long as the inhale), watching my heart rate and using that as feedback to get the rate to change. I'd vary what I was doing based what I was observing. Sometimes the exhale breath holds would work. Sitting in the cool water worked on a 4 hour episode. Converted the 9 hour episode with 3 rounds of Wim Hof and holding the last exhaled breath hold for a very long time (takes a lot of mental stamina for me to do this during afib and is easier in the steady "flutter" rate). I'm sorry I can't give you a method that would always work. I'd just try different things till something worked. Again, using my heart rate for feedback has been useful. I can't always explain why I tried something. I've been watching my heart rate in afib for many years and I just go on my intuition as to what to try.

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Marco
is the area in the atria that doesn't behave properly and cause Afib the same in everyone? if not how is it detected?

Since some research I have done last year, I assume the cause that makes the atria misbehave, it is very different for everyone, if someone ever understand what is the cause, correct?

It's the same areas to some degree. The vast majority of afib signals arise from the pulmonary veins in most people. That's the whole theory behind cryo ablations and ablations performed by less skilled EPs: just burn/freeze a circle of tissue around the pulmonary veins and it will stop 60-70% of afib. That's known as a PVI, a pulmonary vein isolation. Works great until it doesn't.

Afib can arise from anywhere in both atria, so if a PVI doesn't fix your afib, then you either have an EP with little skill and experience or sources of afib other than the pulmonary veins. Either way, it indicates lack of experience on the EP's part because an experienced EP would have found those other sources and dealt with them.

How are they found? They're found by mapping the electrical signals in your heart. The only place beats should be coming from in your heart is the sinus node. If beats are detected coming from anywhere else, that's a problem. A competent EP will find those sources and ablate lines around them to fence them in.

A competent and conscientious EP will not release you from the surgery during an ablation until he/she has either run out of reasonable options and safety for you, or has simply run out of his/her level of experience and expertise. While you are out, and when they are quite certain that they have isolated the entire PV area, they will inject you with two drugs in order: isoproterenol and then adenosine. The former stresses the heart and should...SHOULD...induce AF again if it can be induced in the heart's current state. If the AF happens again, and despite what they thought was a successful isolation of the PV, they will inject adenosine. It slows the heart a great deal (quite an unpleasant 10 seconds or so if they do this prior to cardioverting you while you are awake at Emergency). By slowing the heart, it reveals the discrete pattern of heart signals and shows them if you have flutter, or branch bundle block, and the type of block., or just another focus for AF. In turn, this gives the EP an idea of what else to do before they shock your heart back into rhythm and release you from the operatory.

It's not foolproof. My EP, Dr. Paul Novak, is very highly esteemed in the medical community on Vancouver Island, and he's no fool...believe me. But, he performed what I described above during my first ablation, and it did not go well for me in the weeks that followed. Long story short, he agreed to try once more, and so far, 16 weeks later, I am in good shape with no revealed PACs or AF. Whew!

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gloaming
A competent and conscientious EP will not release you from the surgery during an ablation until he/she has either run out of reasonable options and safety for you, or has simply run out of his/her level of experience and expertise.

Or, until every area of the heart they map is “electrically silent,” as my ablation report termed it. The mapping technology is impressive. They stick numerous pads on your torso before they put you under and they interact with the mapping catheter that the EP uses.

Thanks everyone for the info. I have to say, all of this sound pretty scary.

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Marco
I have to say, all of this sound pretty scary.

Point us to the scary parts and we will try to do a good job of "unscaring" you!

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Daisy

I have to say, all of this sound pretty scary.


Point us to the scary parts and we will try to do a good job of "unscaring" you!

Hi Daisy, thank you.

I pretty much have already anxiety any time I go to a doc office. The idea of having a sort of heart procedure scares me to begin with. Reading what the need to do with injecting different drugs to test my heart, and in case repeat the process or work on a different area sound concerning. I don't know, if I had to do some surgery on my knee it would be ok, but the heart is different. Just thinking they have to insert a catheter in my artery to go up to my hear is somehow frightening. If I need to do this someday, I will need to get some good sedative IV for sure!

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Marco
I will need to get some good sedative IV for sure.

I found that I did want to know all the details—but if you choose a top notch EP to do your ablation you can let go, trust his/her expertise and not even think about the actual process. The important part of that statement is “top notch EP” and there are all too few of them and seeing one often means traveling—but it is so worth it. The complication rate with a top EP working in a top facility is really low and they do ablations all day, every day. What sounds scary and extreme to us is routine for them. And, you are not only given “good sedation,” everything that is even remotely invasive is done after you are under anesthesia. You are positioned on the table with (IV already placed in pre-op) and the anesthesiologist tells you to breath deeply from an oxygen mask, there is a momentary high as they induce anesthesia, then you wake up in recovery with great individual care before being taken to your room. Even the localized prep is done after you are under. The main thing you experience in the EP lab (other than being the center of attention!) is that it is cold but they pile on heated blankets and even run a hose of heated air under them to keep you comfortable.

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Daisy

I will need to get some good sedative IV for sure.


I found that I did want to know all the details—but if you choose a top notch EP to do your ablation you can let go, trust his/her expertise and not even think about the actual process. The important part of that statement is “top notch EP” and there are all too few of them and seeing one often means traveling—but it is so worth it. The complication rate with a top EP working in a top facility is really low and they do ablations all day, every day. What sounds scary and extreme to us is routine for them. And, you are not only given “good sedation,” everything that is even remotely invasive is done after you are under anesthesia. You are positioned on the table with (IV already placed in pre-op) and the anesthesiologist tells you to breath deeply from an oxygen mask, there is a momentary high as they induce anesthesia, then you wake up in recovery with great individual care before being taken to your room. Even the localized prep is done after you are under. The main thing you experience in the EP lab (other than being the center of attention!) is that it is cold but they pile on heated blankets and even run a hose of heated air under them to keep you comfortable.

Thank you Daisy.