ablation procedure

[coffeen]

Prior to the ablation procedure is a tube placed in your throat?  This freaks me out as I am clausterphobic...Do you know when they are inserting the tube?


This discussion is related to Possible PSVT/PAT?.

[coffeen]

Hi Connie,  Thank you for your kind note.  When I found out that I was to have this procedure I was a "train wreck".  I prayed severed times because God says he does not give us the spirit of fear.  On October 13 whan I awoke that morning all fear was gone.  What a gracious savior we have.  I am sure that on the way to the hospital Monday morning I will be somewhat anxious but the initial strong fear is gone.  It was so bad that I even thought about cancelling the procedure.  But as I said I have been released from that fear.  Nice talking to you....Take care, Sally
I know that His angels will be surrounding me on that day....

[Momto3]

Hi.  I've had 2 ablations for PVCs and no tubes : )

My memory escapes me a bit, but as I recall each procedure lasted about 6.5 - 7 hours and I have VERY little recollection of anything.  Not crazy about the IV needle, but no big deal.  Other than that, the only discomfort I remember is when the doctors were closing off the catheter entry site.  They had to apply manual pressure to control the bleeding (that's normal), but that was it.

Try not to let the anxiety get the best of you.  Just think you'll get a little break, a nice afternoon nap and probably a turkey sandwich : )  That seems to be the "standard meal" after the procedure.  Enjoy the season and the beautiful colors, and before you know it, it will be all behind you and you'll be feeling great!  Good luck on the 2nd!
Connie

[coffeen]

Thank you for your comments on long-term studies for ablation.  The doctors are doing thousands of these  weekly around the country and you are right there are no good studies for down the road.  However, prior to ablation open heart surgery was required to fix our problems so I guess we can be very grateful on that note.  My Dr. is supposedly one of the best in this area but when I asked him about this subject his answer to me was that he had been doing these for 15 years which of course did not answer my question. Yes, please tell me about your procedure and how it went for you.  I go in 11/2 for mine.  My Dr. did say that he has never had a problem with heart block so I guess that is good news.  Thank you for your time and concern....Coffeen

[ptadvoc8]

As far as long-term studies go, there are only two that I am aware of and neither, in my opinion, adequately addresses the real issues! The first is an Italian study done on children with WPW and suggests that prophylactic ablations done on children with both episodic and non-episodic WPW may be life saving. This was only one small study on one segment of the population who may be at higher than normal risk for SCD, but it was significant enough to change some protocols as far as who is an appropriate candidate for ablation. The second longitudinal study I found was done in the Netherlands and looked not so much at long term outcomes but at long term quality of life after ablation with control subjects who did not have ablation. Not much to go on really, but the study purported to show about a 30% higher quality of life index for those patients who had the ablation. I think it is shocking that they continue to do ablations like tonsillectomies with NO real longitudinal studies. Even my exceptional doc at Mayo Clinic said there are no long term studies when I asked him point blank about that. He said it concerns him, too, and that Mayo is in the middle of collecting that data because they want to know how this procedure is affecting patients long term. BTW, I had cryo ablation recently at Mayo and if you want more information about my ablation experience, just let me know.

[ptadvoc8]

I had a choice of Cryo or RF for my ablation at Mayo in September and chose Cryo, although the doc and I agreed that if he didn't think he could get it with cryo, he had my permission to use RF and I was very comfortable with that. Cryo-ablation does have some advantages over RF in that it is less likely to cause thromboembolitic events and the lesions from cryo are more controllable since they are basically self limiting and often can be re-thawed if the spot ends up being a bad place to freeze (such as too close to the SA and AV nodes which can cause heart block). RF can continue damaging tissues even after the catheter is removed as the "energy" spreads out in a less controlled manner than cryoablation so "scarring" is less controlled and takes longer to form. This spreading can sometimes mean that weeks or even months after the ablation, heart block may gradually or suddenly occur. Because of this spreading scar tendency, RF is considered to have fewer "relapses" of arrhythmia but more problems with heart block. Cryo is considered to be less successful long term than RF, but less likely to cause heart block. Newer Cryo cath tips and protocols are making it nearly as successful long term as RF, but the docs using cryo do need to be more patient -- my doc worked very slowly then waited a couple of hours and retested the areas to make sure they were really frozen and NOT conducting before he felt comfortable finishing up. Docs do need to be specially trained to use cryo and these days it seems most docs have only been trained for RF. Ideally, any EP specialist would be able to use both Cryo and RF as each have their place in ablation since different patients would optimally receive the approach the best meets their individual needs.

[Mom2four85]

Is the cyro approach just for Afib?

It may take longer, but if they can't get the right place to begin with; as a patient I would much rather it take a few hours longer and not have to have procedure redone.

Interesting info, I'm going to look it up I haven't seen anyone else have this type done.

[Gary3201]

Hi, I was unfamiliar with the cryo approach I have had 2 of the RF ablations. The second was needed when I developed A-flutter a year after the first ablation was done. At the time he did the second one he tried and tried to get my heart to act up by various means so we could make sure we got everything. Well it behaved itself admirably so he thought we were all set. Well don't you know within a week I was back in A-flutter, so at least for now I take Multaq to keep it in check. If it ever gets really bad again I will have them do a third one but for now with the drugs working I feel really good, best I have in years. So don't fret I have always played hard to get........Ha! you will do much better. Good luck and if you want, PM me afterwards and let me know all about it and the outcome

gary

[coffeen]

Thanks for your note, Gary.  I'm hoping one time will due the trick.  I have  done alot of research on this and plan to ask my dr. why he isn't using cryoblation instead of radio frequency ablation.  In case you are not familiar with that is freezing the problem area instead of burning.  If it is not the right place they just unfreeze it and try again.  I think the real reason is probably because it is a much more time consuming procedure than the other.  It leaves no damaged tissue freezing.  Are you doing o.k now and free of your problems?  Thank you again,,,,Coffeen

[Gary3201]

Hey Coffeen, put you mind at ease your procedure will go just fine and hopefully afterwards you will no longer need medications. The procedure itself can vary from a couple hours to maybe 8-10 depending on your uniques situation. There has been no side effects that I know of, except it may not be the only ablation you ever need 2 is not uncommon at all and some have gone up to five I have heard. The only unpleasant thing for me was that they did a TEE prior to the procedure. This is an ultrasound where they insert the probe down through your throat to get as close as they can to the heart wall to check for blood clots. Some drs do this and some don't and even then its only a minor irritation for a day or so. Relax and think positive.

best of luck
gary  

[coffeen]

Yes, I am somewaht anxios re this upcoming ablation on 11/2.  But I think my biggest fear is that to my knowledge there have been no long-term studies to side effects from this procedure as  it has not been around that long.  Has anyone been privy to any research regarding this?

Thanks
Coffeen

[coffeen]

Thank you, Lisa....Coffeen  

[Mom2four85]

If you will look at my journal under surgery it has pacing and the protocols my EP used during my ablation - I put only part of it in there - there's 4 pages I have on what pacing and why was used during the procedure......pacing is also used for pacemakers

[coffeen]

Thank you for your comments on pacing...I am so anxious to get this darn thing over with.  Tell me about your procedure....coffeen

[Gary3201]

I believe pacing in this term, however not positive  is that prior to an ablation they will attach the cardioversion pads front and back so that if needed and the procedure itself does not convert you to regular sinus rhythm they will shock you back. That being said they can also vary the voltage through the pads to pace the heart at different rates during the procedure which I suppose can help them find other trouble spots to ablate during the mapping process.
I am sure there are more knowledgeable folks here than me that may have a better answer for you but this is what I believe it to mean.

best of luck
gary

[coffeen]

What does pacing mean during an ablation.....or is pacing even done at all during the ablation.  Sounds to me it must be related somehow to pacemaker??

Thanks...Due for an ablation 11/2/09

Coffeen

[twinbee]

I had a TEE done too before my ablation. I was put into a twilight for that procedure also.

[Gary3201]

Often prior to an ablation a Dr will request a TEE (transesopogeal echocardiograph) This procedure requires the insertion of a tube through your mouth and down your throat so that they wan insert a probe and do an echo right next to the heart to check for blood clots. They numb you out to do this and it is really no big deal although you may experience a sore throat for a couple day.

gary

[Mom2four85]

I had an Ablation, Cardiac Cath & Pacemaker/ICD implanted all the same week about a month ago.  I didn't have a tube inserted on any of them; and was under wakeful sedation; ask your dr, but I think most don't use them for these types of procedures.

[coffeen]

THank you for your comments....it made me feel alot better about this procedure!

Coffeen

[ireneo]

I've had 3 ablations and they used sedation, not anesthesia where intubating is required. An IV is started in your arm though and that I don't care for.

When I had my abdominal surgery last year they did knock me out (anesthesia) and did put a tube down my throat but they wait until a person is unconscious before they do that. No way they could tube you otherwise. You would fight it and be uncomfortable. When I woke up, everything was out except for the IV.

[twinbee]

I had my ablation done in January 08 for a-fib and a-flutter. My procedure took almost 8 hours. I was not incubated or  tubed. I was put into a " twilight" sleep. Most doctors will just put you in a twilight sleep. Ask your EP what he prefers to do.