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Heart Disease (Expert Forum)
Re: Ablation Concerns
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: Ablation Concerns
by Rodney__0, Jan 01, 1995 12:00AM
Posted By Rodney on July 27, 1999 at 09:25:35
50 Yr. old Firefighter forced into early retirement because of paroxysmal atrial fibrillation. I live in Texas and will travel to OK to meet, what I was told by my electrophysilogist, the best in the business regarding cather ablations. I will try to be brief. Mar. 1995 first episode of A-Fib, since this time a-fib episodes every 6 days at 8am with 8 to 14 hour duration. All test negative, all medications failed. My concern is not the procedure but rather the possible side effects. I was told by my Doc that this Doc. has a 100% cure rate with this procedure. I am somewhat skeptial of course and will question this Doctor about his success rate. I would like suggestions regarding other questions I need to ask this Doctor. I would also your help regarding ANY possible side effects to a cather ablation procedure. This will be helpful when I meet with this physician. It will also assist me with my own self-doubts as to having the procedure.
Thanks
50 Yr. old Firefighter forced into early retirement because of paroxysmal atrial fibrillation. I live in Texas and will travel to OK to meet, what I was told by my electrophysilogist, the best in the business regarding cather ablations. I will try to be brief. Mar. 1995 first episode of A-Fib, since this time a-fib episodes every 6 days at 8am with 8 to 14 hour duration. All test negative, all medications failed. My concern is not the procedure but rather the possible side effects. I was told by my Doc that this Doc. has a 100% cure rate with this procedure. I am somewhat skeptial of course and will question this Doctor about his success rate. I would like suggestions regarding other questions I need to ask this Doctor. I would also your help regarding ANY possible side effects to a cather ablation procedure. This will be helpful when I meet with this physician. It will also assist me with my own self-doubts as to having the procedure.
Thanks
Related discussions
Dear Rodney,
I assume you are going to see Dr. Warren Sonny Jackman in Oklahoma City. He is one of the pioneers in ablation and is very good at what he does. I do think it is an overstatement that he has a 100% cure rate. He can give you a better estimate of the chance of cure and what the exact risks are (in general very low). Here are some other commonly asked questions concerning radiofrequency ablation.
What is radiofrequency ablation?
A radiofrequency ablation or RFA is a treatment for abnormal heart
rhythms. During RFA, your doctor will use a special machine to direct high
frequency electrical energy to remove areas of the heart muscle that cause
the abnormal rhythms. It can also be used to "disconnect" the electrical
pathway between the upper chambers (atria) and the lower chambers
(ventricles) of the heart. The type of RFA performed depends upon the
type of arrhythmia you have.
What to do before a RFA.
Should I take my medications?
Your doctor may ask you to stop certain medications (such as those that
control your heart rate or aspirin products) one to five days before your
procedure. Ask your doctors which medications you should stop.
Can I eat?
You must have an empty stomach. Do not eat or drink anything after
midnight the night before your procedure. If you must take medications,
drink only small sips of water to help you swallow your pills.
What should I wear?
When you come to the hospital, wear comfortable clothes. It is best not to
wear any jewelry or valuables.
What should I expect during the RFA?
Where does it take place?
Your test will take place in a special room called the EP
(electrophysiology) lab. Before the test begins, a nurse will help you get
ready. The nurse will start an IV (intravenous) line, This is so the doctors
and nurses may give you medications and fluids during the procedure if
necessary.
Will I be awake?
It is common to be nervous. A light sedative will be given to you through
your IV to relax you and make you drowsy. This medication will not put
you to sleep. You will be asked to report any symptoms, answer
questions or follow instructions given to you by your doctor. If you are
uncomfortable or need anything, please let your nurse know.
Will I be monitored?
The nurse will connect you to four monitors:
Defibrillator/Pacemaker:
Attached to one sticky patch placed on the center of your back and
one onto your chest. Allows the doctor and nurse to pace your
heart rate if it is too slow or deliver energy to your heart if the rate is
too fast.
Electrocardiogram or EKG:
Attached to several sticky electrode patches placed onto your
chest, as well as catheters placed inside your heart. Provides a
picture on graph paper of the electrical impulses traveling through
your heart.
Oximeter monitor:
Attached to a small clip on your finger. Checks the oxygen level of
your blood.
Blood pressure monitor:
Connected to a blood pressure cuff on your arm. Checks your
blood pressure intermittently throughout the study.
These monitors allow the doctor to check your heart rhythm and
the body's responses to arrhythmias.
What are catheters?
The catheters used by the electrophysiologist are special wires that can
pace the heart and precisely record its electrical activity.
How does the doctor insert the catheters into my heart?
Your groin area will be shaved and cleansed with an antiseptic solution.
Sterile drapes will be placed to cover you from your neck to your feet. A
light restraint will be placed across your waist and arms to prevent your
hands from coming in contact with the sterile field.
The doctor will numb your groin by injecting a medication. You may feel
an initial burning sensation, then it will become numb.
The doctor will then insert several catheters into the large blood vessel(s)
in your groin. The doctor will use the fluoroscopy machine to guide the
catheters into your heart. It is important that you remain still and resist the
temptation to raise your head to see what the doctor is doing while the
doctor places the catheters are being placed.
Sometimes, it may be necessary to use both an artery and a vein.
What will I feel?
After the catheters are in place, the doctor will look at the monitor to
assess your heart's conduction system. Then, the doctor will use an
external pacemaker to give the heart electrical impulses to increase your
heart rate. You may feel your heart beating faster or stronger when your
heart is paced. If an abnormal heart rhythm occurs, the nurse will ask you
how you are feeling. It is very Important to tell the doctor or nurse the
symptoms you feel.
The doctor will then move the catheters around your heart to see which
area(s) your arrhythmia is coming from. Once the doctor finds the area of
your heart that causes the arrhythmia, energy is applied through the
catheter. You may feel some discomfort or a burning sensation in your
chest. This is normal. During this time you must stay quiet, keep very still,
and avoid taking deep breaths. If you are extremely uncomfortable, tell
your nurse or doctor and more medication may be given.
How long does on RFA last?
About 2 to 6 hours.
Are there any risks to an RFA?
Radiofrequency ablation is generally very safe. However, as with any
invasive procedure, there are risks to having an RFA. Special precautions
are taken to decrease the risks. Your doctor will discuss these risks with
you. Any specific questions should be directed to your doctor.
What should I expect after the RFA?
When will I find out the results?
Results of the procedure will be given to you and your family after the test.
Your doctor will also discuss when you can resume activities.
If you have any other questions, please ask your doctor or nurse.
Will I have to stay in the hospital after RFA?
After RFA you will be admitted to the hospital. You will be taken to your
room and placed on a special monitors called telemetry. Telemetry
consists of a small box connected by wires to your chest with sticky
electrode patches, The box causes your heart rhythm to be displayed on
several monitors on the nursing unit. The nurses will be able to observe
your heart rate and rhythm.
You will be discharged the next day and given follow-up instructions.
Many individuals feel extra heartbeats on and off for a few weeks.
Sometimes you may also feel as if your tachycardia (fast heart rate) is
starting, but then it stops. These sensations are normal and you should not
be alarmed. If however, your tachycardia reoccurs, notify your doctor.
How do I care for the wound site?
After the RFA, the doctor will remove the catheters from your groin. To
prevent bleeding, the doctor will apply pressure to your groin area for
several minutes. Then, you will need to be at bedrest for one to six hours.
Keep your legs as still as possible during this time to prevent bleeding.
No stitches are needed. Your incision will have a small sterile dressing on
it which can be removed the next day. Keep the area clean and dry.
Report any redness, swelling, or drainage at the groin site to your doctor
or nurse.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Thank you, your comments have been most helpful. I will keep you informed.
Thanks. We always love to hear the success stories but let us know what happens either way.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Follow Ups:
Ablation Concerns Rodney 8/07/1999
(1)
Re: Ablation Concerns CCF CARDIO MD - CRC 8/09/1999
(0)