Pre-Procedure / Post-Procedure Instructions |
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Catheter Ablation Before the procedure: Your healthcare provider might ask you to have your bloodwork (INR) checked about a week or a few days before your procedure so that we can be sure that your blood is not too thin for the procedure. Medication instructions:
Also, you will be asked not to have anything to eat or drink (including water) for 6-8 hours before your procedure. You may be allowed to take your other medications that morning with a small sip of water, but talk to your doctor first. You may be asked to have a TEE a day before or on the morning of your procedure. At the time of your procedure, you will be taken into the EP lab (electrophysiology procedure room). This looks like an operating room, and has special X-ray equipment, and monitors around the room which will be used to help the physicians look at your heart. An intravenous line (IV) will be started in your hand or arm. This will be used to give you sedatives, pain medicine, and heart medicines during the procedure. ECG patches and other monitoring equipment will be attached to you so that the staff can monitor your heart rate and blood pressure during the procedure. There areas on the groin, neck or arm may be cleansed and shaved to prepare for the placement of the special procedure catheters.
During the procedure: The areas of the skin where the catheters will need to be inserted will be numbed. This may sting at first, but will quickly pass. The special soft, flexible catheters or tubes will be inserted through this numbed area. A very small incision will be made in your skin in order to let catheter be placed into the vein. You may feel pressure but you should not feel any pain. If you do, tell the nurse. The catheters are then passed or advanced into your heart while the physician uses the special x-ray (fluoroscopy) to monitor the catheter’s progress and position. After the procedure: Once the procedure is done, the doctor will remove the catheters from the veins. One of the physicians or nurses will hold pressure over the area where the catheter was inserted while the opening forms a clot. This usually takes 10-20 minutes. You will continue to be monitored during this time. Please let the nurse know if you feel uncomfortable. Once you are fully awake, the nurses will take you back to your room. A heart rhythm monitor will be applied there so that we can continue to monitor your heart rhythm overnight. You will need to lay flat in bed for a few hours (the nurse will give you specific instructions) to prevent bleeding or oozing from the catheter insertion sites. After several hours, you will be allowed to sit up and walk around your room. You will be discharged the next morning after the AFC team has reviewed your heart rhythm from overnight, and checked your dressings. Often, the dressings will be removed before you go home. Special instructions:
You may be quite tired for a few days after the procedure. Some people feel aching muscles in their arms, legs or back because they were lying in the same position for several hours. You may notice bruising in the areas where the catheters were inserted. These bruises should resolve in a few weeks. If the bruises get larger, or you notice new bleeding or oozing after you go home, you should call your doctor. If you notice any pain, tingling or numbness in your leg on the side where the catheters were inserted you would want to call your doctor. You will be seen in the AFC about 4 weeks following your procedure to check your heart rhythm and review your medications. Some medications may be stopped after that visit. Sometimes, in the first weeks or months after this procedure, you may feel your heart start to go into Afib, but then it stops and stays in normal rhythm. This is normal, and often referred to as “start up beats”. It simply means that the Afib wants to “start up” but the barrier or scar created by the procedure has worked to stop the AF. This usually goes away or you become used to it and no longer feel it. Other patients may have a few brief episodes of Afib after the procedure. This is often related to the irritation of the heart tissue from the procedure itself. This does not necessarily mean that the procedure failed. It is important that you call the AFC team to let them know if you have an episode of Afib. It is not an emergency, but if the AF lasts longer than 12 hours, the doctor may want to do a CV and put you back into normal rhythm. |
