The actual ablation procedure – everything you ever wanted to know (and maybe more):
My husband and I got up at 4:45 am, showered and dressed, and headed to the hospital at 5:45 am, as I needed to arrive at the admitting desk by 6:30 am. Traffic wasn’t too bad and we arrived a few minutes early, parked the car, and headed into the hospital. I was feeling terrible and even though I was walking very slowly from the parking lot to the entrance, my heart was really acting up and I thought I was going to have an SVT attack any minute. The clerk at the admitting desk was very nice and I showed her my identification and insurance card, she asked several questions, had me complete and sign some forms, and collected the co-pay. I gave her my advanced health care and HIPAA directives, then she gave us a receipt and showed us to the waiting area. As we waited, I could see the sunrise through the window and thought to myself how nice it was that it was such a bright sunny new day and the beginning of a new life and heart rebirth.
A few moments later, a hospital staffer came by to escort us to the EP lab. She asked me if I wanted a wheelchair for the short walk to the elevator. I said no and was sorry afterwards as it turned out to be a longer walk than I thought it would be. We arrived at the elevators and took an elevator to the eighth floor EP lab.
We were only in the waiting area for about 5-10 minutes before a nurse came looking for us. I saw a restroom and took the opportunity to use it before we began with the pre-ablation preparations. After I was finished, I was asked to change into a johnny, and miracle of miracles, it was a new one that was roomy and comfortable and actually tied in two places in the back so I didn’t catch a draft or inadvertently flash anyone. I was allowed to keep my shoes and socks, and all my other clothing and my coat went into two plastic bags that were kept with me throughout the day. I was seated in a comfy chair and the nurse proceeded to check my identification, birth date, and what procedure I was having done (safety precautions). She then hooked me up to a pulse monitor, a blood pressure cuff, and an IV. Of course, as soon as she was done, I had to visit the restroom again. But she was great about it, disconnected the BP cuff and the pulse monitor and walked me to the restroom holding the IV tubing and bag. Once I returned, the BP cuff and pulse monitor were reattached, and I was draped with heated blankets, as it was kind of chilly.
My doctor stopped by to meet my husband as they had not had the opportunity to meet previously. They hit it off quite well. The doctor explained the procedure and gave my husband an estimate of how long the procedure would take (2-4 hours) and how long I would be in the recovery room (about 3 hours). The doctor took my husband’s cell number, gave him the number for the EP lab, and promised to call my husband as soon as I was moved to the recovery room. (I had encouraged my husband to go home and work from home, rather than sit in the waiting room, which would make for a very long day. Also, I was hoping he could get some rest as neither one of us had slept well all week.)
By then it was time for the ablation procedure. I believe it must have been somewhere between 7:30 and 8:00 am – not sure as I didn’t have a watch. I kissed my husband and gave him a big hug and then he left and I was accompanied by one of the nurses to the EP Lab.
The EP Lab looks like a big computer room, only with medical equipment and a slightly larger than stretcher-sized table. The nurse took my shoes and asked me to sit on the table so they could apply electrodes and other items. I was painted with a blue liquid disinfectant/germicide from mid-stomach to just above my knees, except for the catheter area and private parts. It was rather cold in the EP Lab, even more so than the room I was previously in, and I was shivering a little bit. Apparently they keep the electrodes refrigerated because they felt very cold as they were applied. When everything was done, I was hooked up to oxygen and one of the nurses helped me to lie down and get settled in and made sure I was comfortable. A foam wedge was placed under my knees. Then the armrests were adjusted and my hands were restrained so I couldn’t accidently pull anything out during the procedure. I was asked to lie flat and as still as possible during the procedure. I was then draped with warm blankets, one from the top of my head down the sides of my neck, and the other across my body, with the exception of the groin area where the catheters would be inserted. I was given a quick “trim” by the nurse and afterwards my private parts were covered as well.
Next, I was introduced to the other doctor who would be assisting my doctor with the procedure. He was very pleasant and I liked him very much too. This doctor would be inserting the catheters, one on each side of my groin, and he would be maneuvering the mapping and ablation wires. My doctor would be doing the EP study and mapping on the computer on the other side of the room and instructing the other doctor where and when to burn. I believe they said there were two wires in one catheter and three in the other.
The anesthesia being used was “conscious sedation” where I would be given sedatives (Versed) and pain medication (Fentanyl). It is necessary to remain conscious and alert for certain portions of the procedure. My preference was to remain conscious for the entire procedure as I was very interested in what they were going to be doing and I was happy they were willing to accommodate my wishes. (You’re probably thinking “This gal is crazy”, right?) I was told if I needed additional sedatives or pain medication I only needed to say the word and the nurses would administer more. They made every effort to ensure my comfort and the nurses were always close by, constantly checking to be sure I was feeling OK.
Next step was the insertion of the catheters. I was given several shots of Novocaine at the catheter sites. Unfortunately for me, I have a high tolerance to pain medication and Novocaine and I need more than the average person in order to achieve the desired effect. I notified them in advance, as I wanted to be completely numbed before they started inserting catheters and wires. Also, I dislike needles with a passion, always have. Once I was numbed, the doctor began inserting the catheters. I only felt pressure as this was being done. He seemed to have a more difficult time with the left side than the right side. Wish I could have observed what he was doing, but I couldn’t see anything that was going on as I wasn’t allowed to raise my head. However, the nurses explained everything that was going on every step of the way. My guess is that the preparation time took about an hour.
To be continued - See Part 2, Section 3..........