SVT/AT/AFIB Ablation

I'm 63 years old. I have a St. Jude/Medtronic Dual Chamber pacemaker since early 2019. Was told I had SSS. All went well until this past year. I started feeling rather unwell, short of breath, fatigue, and just blah. Blood pressure became uncontrolled and high. We tried several new meds to get it down, Lisinopril HCTZ & CARVEDILOL.  I told my cardiologist that something still wasn't right. He ordered echocardiogram, carotid scan, and nuclear stress test. Nothing was found. I kept complaining and finally he had me to meet with my EP who after listening to my complaints had me wear a Zio Monitor for 2 weeks. It showed SVT's & Atrial Tachycardia. So he recommended I have an ablation. This is scheduled for June 27th. However, 2 weeks after my Zio Monitor was complete, my Merlin monitor sent an alert to my doctor showing several A fib episodes. When he scheduled my SVT/AT ablation he said I would receive Monitored Anesthesia Care. Now that I also have AFib and on Eliquis, I'm wondering if I will receive general anesthesia, since I have AFib. I've left messages with his office, but it takes a while to hear back. Anyone out there have a similar experience?


4 Comments

Anesthesia

by AgentX86 - 2023-06-17 02:22:48

I highly doubt that you'll get general anesthesia.  The chances of complications from general anesthesia would be more likely and worse than the ablation itself and the recovery time significantly longer (if not overnight).

They usually use twilight sedation, though ablations aren't really a big deal.  I've had three (of four) ablations and a carotid angiogram with only a local (including my PM implant/AV ablation). There was significan't pain when they made the pocket for my PM but the others weren't a problem at all. 

Don't worry.  Youll be fine. It's really a simple procedure.

 

Do you want a General Anaesthetic?

by Gemita - 2023-06-17 07:08:04

Angkbee, Firstly I am sorry to hear that your arrhythmias have started causing symptoms and that AFib has also been seen.  I know AFib well and being “symptomatic” is certainly a reason to proceed to an ablation which is usually around the pulmonary veins.  An ablation is often more effective in treating an arrhythmia like AFib than medication alone.

I am in the UK and my EP usually offers a choice of anaesthesia.  I am not very brave and will fight my doctors all the way unless I am knocked out.   I had a general anaesthetic (GA) for my pacemaker implant for example whereas many patients have it done under conscious sedation.  Actually my EP's choice for me was a GA.

I considered an ablation some years ago.  I am aware that an ablation can be a fairly lengthy procedure depending whether they see the arrhythmia at the time and then can pinpoint the exact place to ablate.  Sometimes the arrhythmia is not active at the time of your procedure and it can therefore take longer to trigger or to trace its origins.  Because of this I would want a GA.  Yes it will result in a longer recovery and overnight stay in hospital, and will have its risks (as will an ablation), but I would rather be completely unaware of what is going on and be free from any discomforts than to go through up to a few hours of symptoms.

I would speak to your doctors about your choices?  Here in the UK some hospitals offer a GA for an ablation, especially if it is likely to be a long or complicated procedure.  But perhaps you don't want a GA and will sail through the procedure on light sedation only?

I hope all will go well on the 27th June.

Anesthesia

by Julros - 2023-06-17 10:11:19

I recently underwent an atrial flutter ablation (second one) and an atrial fibrillation ablation. My doctor prefers general anesthesia because they insert a probe into the esophagus to monitor the heat emitted to be sure the esophagus isn't damaged. She used radiofrequency ablation and the procedure took 6 hours. I was grateful not to be awake for that. I was discharged that same evening. 

I too, am on Eliquis, and had to hold the dose the morning of procedure, and then resumed when I got home. I felt very hyper for two days, I suspect because I was given steroids to prevent nausea and vomiting. 

Anesthesia

by godrew - 2023-06-17 16:29:29

I had an ablation under general anesthesia, supposedly it took almost 6 hours.  I obviously did not know how long it was, but that is what Dr told me.  He thought it was going to take 2.5-4 hours but I guess he was wrong. As far as I know I had no issues or complications with the anesthesia, just very sore after in the groin area where they went in.  Not sure where your at, but I'm in the states.  Good luck.  Anesthesia for me gives me a slight headache for the next 24-36 hours after procedure.   

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