Ablation - what is it like?

I would like to know what the ablation procedure is like - it sounds pretty scary to me yet many people on this forum have experienced it.  Some people report the procedure is many hours in length.  Are you asleep for this or awake or somewhere in between?  Is it extremely uncomfortable - can you feel the catheter(?) inside your veins and in the heart?  Is there any sensation when the pathway is ablated.  Anything you can tell me about the procedure from the pateint's point of view would be appreciated.  I am a nervous nelly for sure, although if offered an ablation, I think I should accept it rather than take medication for the rest of my life.  Is a cardiac MRI always done prior to this procedure (mine would be for NSVT)?  I am even scared of having that done!  Thanks for any reports of your experiences.  

[Brooke_38]

Hi Liz...

I guess having been to the lab 5 times, I would consider myself a veteran *LOL* Each procedure was a unique experience and I think it was mostly in part to the level of sedation. I was awake for 4 of them and only 1 of them was I completely out from start to finish.

Upon arriving in the lab (OR) they have you slide from the stretcher to the table. Once you're on the table, the EP nurses place the littles sticky electrodes all over your torso along with pacing pads (1 on the front and the other just below the shoulder blade.

At this point you are sedated, usually with Versed and Fentanyl. I do remember the Dr making the groin incisions, I didn't feel anything except for some pressure as the catheters were guided through the femoral veins. The sedation I had at this point was light. At this point, the Dr maps the electrical conduction in your heart. This can be uncomfortable due to the pacing that is done as he is trying to initiate your arrhythmia. Your heart rate is paced up and down during this time. I begged them to knock me out completely. I was told that it is neccessary during this portion of the study to be semi awake. When patients are more heavily sedated, it makes provocation of the arrhythmia more difficult and sometimes unable to provoke at all. If they can't get the rhythm to run, they will not be able to ablate.

Once the arrhythmia is found, there is excitement in the lab, and at this point you are then sent to "la la" land for sweet dreams. Depending on how heavy the sedation will determine what you recall next. Sometimes I awoke in the lab following the procedure, other times I awoke in recovery. Length of the procedure depends on how much time it takes to find the "hot spot" and then if they are able to reproduce it following the placement of the burns. My lengthiest procedure was 8 hrs and shortest was 3.

Once you're off in recovery, you are lying flat for at least 4-6 hrs. You are not able to move or bend your legs. This is important becuase any movement or bending could interfere with healing of the groin incision. Some people are lucky enough to go home the same day while other's may spend the night as an inpatient. I stayed overnight 3 out of the 5 times.

I can completely relate to your anxiousness but think of  what life can be like not having to worry about your arrhythmia anymore:) I havne't been through a cardiac MRI so I can't attest to that expereince.

If an ablation is offered to you....You can do it my friend, I know that you'll be strong and brave:) We'll support you the best way we can!

[rbeans]

Listen to Brooke!!!! I had an ablation back in Nov. No pain some discomfort. I was awake for 3 out of the 6hrs. It is scary to think about what they are going to do. I worried myself sick.

It was not as bad as I thought it would be. I am VT and Pvc free now! so it was worth it.

[Liz4914]

Thank you so much Brooke for describing the ablation procedure - I would rather know what to expect than not.  It does sound scary but I will accept it if I have the opportunity to have it done.  Thank you rbeans, too!  It must be worth it not to have to worry about VT.  I am just a worrier - how does one become brave?

Another question, can you still get NSVT if you are taking a beta blocker or will that block any possibility of another episode?  So far, touch wood, I have been OK but have had a lot of other "benign" arrhythmias going on (except when I am given an event monitor in which case they disappear!).  Only another week until my appointment with an electrophysiologist for an opinion.  

Thank you again for your support - maybe one day I will be picked up by the limo :-)