Discharge Summary Post Ablation

[LaurieAVNRT]

I had a catheter ablation three weeks ago and I am quite scared about the results.  I have arrythmias every day - all day.  I record events and submit on a monitor but don't get feed back from the physician who performed the ablation.  I would like to transfer all my care to my local cardiologisy but the discharge summary only state that I was treated for AVNRT and that they treated the short pathway and they consider the procedure a success and I no longer need heart meds.  I have never felt worse in my heart.  I wanted to know the locations of the lesions, how many, the duration of the lengths of the radiofrequency, etc.  The physician states he only provides "Clinical Notes" for this procedure - which is a one page hand written summary.  Shouldn't it be standard that they provide more detailed information in the discharge summary since this is such a new procedure?  I am 42 and want to know everything that was done so I can help my self with side effects in the future.  Shouldn't there be a minimum of information provided to patients?
I also know they had to insert another catheter and I want to know why.  They are trying to tell me it is just part of the procedure, but I know they were using state of the art equipment which should have been able to map and ablate through the same catheter.  I think there is computer equipment that records the diagnosis and procedure and I want a copy of that print out but I dont know how to ask for it.  I have requested all medical records and it is not there.  Does anyone have any suggestions?  I am really upset about this whole thing which makes it even harder to heal.


This discussion is related to Catheter ablation for atrial fibrillation.

[ireneo]

Well, after my ablations I asked for notes about what they found and what they did. In truth, the notes were a bit too detailed for me and I spent some time looking up the various terms (just where is the crista terminalis and tricuspid annulus?) I had a general interest in what they found and how many RF applications they had to make (38 total). Any more than that made no difference on the outcome.

Three weeks isn't long at all for recovery after an ablation. Depending on how long they were in there (my 2nd one took 7 hours), how many times they had to burn the pathway(s) it can take a few months for the heart to heal. The tissue takes time but it also irritates the heart and it will be jumpy for awhile. If you've ever had other injuries you know the wound will be sensitive and tender even after the last scab is gone.

I don't think ablations are a "new procedure." I believe they've been around for at least 15 years. My first ablation was 8 years ago and it wasn't considered all that new even back then.

As for catheters, it's normal to have 4 catheters (2 in each femoral vein) and sometimes one more is used near the neck. I only had the 4.

At this stage I'd say it's too soon to say whether your ablation was a total success. They ablated the spots causing problems, tried to initiate the arrhythmia again and couldn't, at which time they think it's probably fixed. But only time will tell. It's no reflection on their technique or skill. If they can't trigger it, it looks like it's ablated.

[LaurieAVNRT]

Thank you so much for your information.  I feel I really need a good support group at this moment.  What were you ablated for?  I had one catheter in each groin and another in my neck, then the 4th was added to my RF with the other one.

Did you have to  take blood thinners for a month afterwords?  They have me on 325mg of aspirin.

My current concern is that I have woken up the past two mornings with atrial fibrilllation which I have never had before.  I am concerned about a stroke.  Should I be?

Sheesh - it sure would be nice if my doctor would help out.  The stress makes things so much worse.

[ireneo]

I went in to have my atrial tachy ablated. They also found the usual PVC's and PAC's plus some "chaotic atrial flutter." As far as I know the atrial flutter (a step below a-fib) was ablated and my PSVT is still hanging around but not nearly as bad.

Before my ablations I was told I would have 4 catheters put in with the possibility of the 5th in the neck. Fortunately I didn't need the 5th. So having 4 in as you did is not unusual. It's just nice if the doctor explains it all before the procedure. Not all doctors take the time.

I was supposed to take aspirin (81mg) after but I didn't do it much. The bruising and bleeding was more than I could handle even from that small amount. Even now when I go in to see any of the doctors, they ask if I'm taking my aspirin. I just look at them innocently and say, "Oh, am I supposed to?" and they never answer.

How do you know you have atrial fib going on? I've never had it but many who do seem to "feel" it differently. Some folks are very symptomatic, some don't feel a thing. From what I've read short periods of a-fib will not cause blood clots. Those who have longer periods of a-fib need to think about that and deal with it. Wish I could remember the time involved. It seemed like 30 minutes or something along that line. If you strongly suspect you're having a-fib, see your doctor and wear a monitor to record it. That's not something you want to ignore for any period of time.