ABLATION QUESTIONS

IVE HAD WPW FOR YEARS  AND HAVE BEEN ON MEDS THEY DONT WORK SO IVE SEEN A ELECTROPHYSIALOGIST AND HE WANTS ME TO WEAR A HOLTER MONITER AN EVT WITH A CELL PHONE FOR 3 WEEKS AND THEN WHEN HE CAPTURES IT I WANT AN ABLATION BUT I WANNA  BE PUT UNDER GENERAL ANESTESIA DO THEY DO THAT AND GENERALLY  HOW LONG DOES IT TAKE AND  DO U HAVE TO STAY OVERNIGHT IN THE HOSPITAL ANYONE KNOW? I COULD NOT HANDLE BEING  JUST LOCAL

[stutterheart]

There's no chance that they'll give you general. They'll give you local in your leg and a 'twilight sleep' which just makes you a bit spacey. You'll feel the wires in your arteries, you'll feel the shocks and burning and you'll be really freaked out when they tigger arrhythmia. It ***** and it hurts. But it's worth it for sure and it's definitly bearable. I wasn't scared to go in there the first time and I'm not scared to go in there again even knowing it's a scarey and painful process (8 hours for me).
Good luck.

[twinbee]

My ablation for a-fib and flutter  in January 08 took almost 8 hours. I was put in a "twilight" however I was totaly out 90% of the time. And when I did wake up, they sedated me again. The only thing I felt was  alittle burning from the novacaine in my groin. I DID NOT fell wires in my arteries, I DID NOT feel the shocks and burning. I do remember them telling me they were going to trigger the arryhythmia, but I DID NOT feel it or get freaked out. I also had no groin pain or bleeding after the procedure. The only complaint I had was alittle chest pain whenever I took a deep breath(this went away in a day or two) and my back killled me due to having to lay flat for soo long. The nurses did give me pain meds for my back pain and that too went away the next day. I did have to stay in the hospital for a few days. They needed to get my coumadin levels stable. I do know that it is becoming more and more common to be put totally out during ablations. Dr Natale is doing this now. Check with your EP.Good Luck. Wishing you well and wishing you enough...

[ptadvoc8]

I also have WPW and have put off having an ablation for years, but am now looking to have it done when I have decided on the right person, right place and right time.

There are facilities that commonly use general anesthesia in some types of ablation cases. In fact Dartmouth in NH was insistent that if I had an ablation there, they would only do it with general in my case, which is why I am looking into other places. I'm one who absolutely doesn't want general anesthesia. There are both benefits and risks to general anesthesia, which is why they tend to use it on a case by case basis. Often it is in the patient's best interest to stay at least overnight in the hospital so they can monitor things after the procedure -- this practice varies from facility to facility.

On the plus side, general ensures an immobile patient with an open airway and when they threading wires through your vessels and burning your heart, being immobile  with an open airway is a good thing. Also, some procedures can last a very long time and being totally out can make it easier for the patient and the physician. Some people (like me) have had bad reactions to the drugs (like Versed) they use for "twilight" sleep, so having a full fledged anesthesiologist (as versus a Certified Nurse Anesthetist) there to keep someone in general can be safer than basic sedation.

However, general anesthesia is much more complicated than sedation and has higher risks to the patient. Post anesthesia nausea and vomiting is much more common after general anesthesia than sedation. Sometimes it can actually help the EP specialist to be able to talk to the patient about the arrhythmias they trigger in the EP lab, so being conscious may be important in that respect. Also, it costs more to have a general and some insurance plans don't want to pay for that.

Before scheduling your procedure, ask to speak to the EP specialist AND the anesthesiologist -- even if you only speak to them by phone about your concerns. Often they just want you to do that on the day of your procedure right before you go into the EP lab, but there are some good studies that suggest it is better for many patients to do this well before the procedure for ease of mind and gathering more accurate information from patients. It's your body, so get the information you need to make the best decisions for yourself with your doctors.

One other thing that has been shown to help for patients undergoing either general or sedation, are "pre-prpcedural'" audio CDs that help you learn to relax and envision a positive procedural experience. They are available on-line and at many hospitals, so ask your EP or Anesthesiologist about them.