Hi Travis: I have had two ablations. My first ablation, I felt very wiped out and experienced alot of chest pain for the first 2-3 days. My second ablation I didnt feel as wiped out which was actually kind of ironic because I suffered a complication with my second one. In my opinion, I think if you were planning to fly back home after three days, just take it easy. No heavy lifting so be sure you have someone who can handle your luggage for you and I would suggest taking it slow through the airport, give yourself plenty of time, minimize the stress as much as possible. Depending on the length of walk through the airport to your gate, I might even consider hitching a ride with one of these golf cart guys that transport people to their gates, if available. Good luck to you! February 2nd will be here in no time! Being well prepared will make things go smoothly. Take care, Carrie

Hi Travis, in addition to what Carrie said I think it might also depend on whether or not you had a GA or local with a sedative. I had the local for both my ablations and felt normal (as far as me and normal fit together) 3 days after.

My second ablation was also on a Monday I went home on Tuesday morning. Hung around on Wednesday and didnt do much.

On Thursday I took the train to the hospital got a mammogram and a heart MRI and then took the train back home. I dont remember if I walked to and from the hospital or took the tram I usually walk but I think I took the tram that day, still taking it easy. Total train travelling time about 2 hours. So I was up and going (but not dragging any baggage) about 5 or 6 hours. Tiring but doable.

The day after that (that would be Friday) I helped move an aunt into a assisted living. Okay, so I basically stood around and cracked the whip in the morning and let the moving-men lift and grunt, but I did tag everything that had to be moved and someone had to stand around and watch. Then in the afternoon I helped unpack in her new home. I felt fine but I didnt lift anything more than 5 kg at a time (and only broke one thing!).

I believe Saturday I slept in. :-)

Just dont overdo it. Like Carrie said, if you are going through any huge airports like OHare or Atlanta take whatever help you can get. Get someone to pick you up and drive you home from there just to be on the safe side.

Take care!
atp

Well Travis, I had a general, and wasn't fit to do much of anything for several days. And don't forget that do want to be careful of those arterial punctures. You really don't want to screw with those. Keep in mind that they pump you full of blood thinner when they do the procedure. Rupturing one of those punctures in the airport will be the end of the story. Also, you really don't know how long they will keep you in the hospital. Some of us (not me, I think Bill) had to stay several extra days because the punctures wouldn't close. Make sure you get a flexible plane ticket.

My advice is stay in a hotel for a few more days, pushing it is not worth the risk.

These young guys, they all think they're indestructible !!! --g--

Travis,
Paul is correct, I had to spend 2 nights in the hospital cuz the entry wounds were oozing. I remember them saying that it wasn't that big of a deal, but if I went home and saw a lot of blood on the sheets I would freak out. I said I wouldn't, but I think they knew me better than I know myself! So I agree with Paul, if at all possible just plan to hang out for a few extra days just in case. And I am sure it will be MUCH warmer and nicer in Texas in February than it will be in...are you from Wisconsin? Did I remember that correctly?
Best of luck with the ablation, but you have THE man doing it, so I don't think you need to worry one little bit (easier said than done, I know).

Bill

Thanks everyone. It sounds like I should give myself at least a couple extra days - maybe fly back Saturday instead.

Bill - You were close. I'm right next door to Wisconsin - Minnesota:) I would be just like you too. If anything "oozes" from my body I'll freak too!

Travis

Good luck trav

Glad you decided to hang out for a few extra days, I think you will be glad you did,Good luck with our procedure!

Travis - Are you having a general anesthesia?

I have no idea if I'm having general anesthesia. They said I would be asleep for the entire procedure. They said they want me out completely during the ablation. I'm assuming that's general anesthesia, right? What's the difference? And how does GA make things worse? You're not telling me that some people are actually awake during this procedure, are you? That sounds really scary to me.

Travis

ATP was awake, she has more guts than the rest of us. The thing with general is you tend to be kind of dopey for quite a while

Travis,
You will be given general anesthesia, totally paralyzed and in a medically induced coma, so Natale will perform precise deep burns on a dead body that won't move. That's one of the reasons he's the cream of the crop.

General anesthesia associated with better ablation results

AUSTIN, TEXAS. Catheter ablations for atrial fibrillation (AF) are usually performed with the patient under conscious sedation, that is, awake, but sedated to minimize pain and movement during the procedure. The most commonly used agents used in achieving conscious sedation are a combination of fentanyl (an opium-like drug) and midazolam (a benzodiazepine). The conscious sedation approach unfortunately does not guarantee that the patient will keep still or that their breathing will be regular both important factors in ensuring catheter contact and stability. In order to overcome these shortcomings, several electrophysiologists (EPs) now use general anesthesia when performing catheter ablations for AF.

A team of EPs from St. Davids Medical Center and California Pacific Medical Center now report the results of a randomized study to compare the efficacy and long-term outcome of ablation procedures performed using general anesthesia with that of similar procedures using conscious sedation. The study included 257 patients with paroxysmal AF who were randomly assigned to undergo a pulmonary vein antrum isolation procedure (PVAI or Natale protocol) with conscious sedation (group 1 128 patients) or general anesthesia (group 2 129 patients). The average age of the patients was 59 years, 75% were male, and 86% had lone AF (no coronary heart disease).

A combination of electrophysiologic mapping and intracardiac echocardiograms (ICE) was used to guide the ablation with a 3.5-mm irrigated-tip catheter. An esophageal temperature probe was also used to prevent damage to the heart wall adjacent to the esophagus. All patients underwent complete pulmonary vein isolation after which the catheter was positioned at the junction of the right atrium and the superior vena cava where mapping and ablation was performed in 86% of patients. Additional non-pulmonary vein triggers were ablated in 11% of group 1 patients and in 10% of group 2. Follow-up examinations were performed at 3, 6, 9 and 12 months after the procedure and included 7-day Holter monitoring. Recurrence was defined as any episode of AF or tachycardia lasting for at least 30 seconds after an 8-week blanking period.

At an average of 17 months after the initial procedure, 69% of group 1 were free of arrhythmia without the use of antiarrhythmic drugs as compared to 88% of group 2 patients. The only variable independently associated with freedom from recurrence was the use of general anesthesia. Recurrence was experienced by 31% of group 1 patients and 12% of group 2 (general anesthesia) patients. All underwent a second procedure during which it was discovered that 42% of ablated pulmonary veins in group 1 had recovered conduction as compared to only 19% in group 2. Fluoroscopy and total procedure time were significantly shorter in group 2 (53 minutes and 2.4 hours respectively) than in group 1 (84 minutes and 3.6 hours). No major complications were observed in either group.

The study authors attribute the better outcome for procedures performed under general anesthesia to greater stability of the ablation catheter resulting from the fact that the patient is immobile and breathing is regular.

Di Biase, L, Natale, A, et al. General anesthesia reduces the prevalence of pulmonary vein reconnection during repeat ablation when compared with conscious sedation: Results from a randomized study. Heart Rhythm, Vol. 8, March 2011, pp. 368-72

He's researched every aspect of ablation from anesthesia to the new blood thinners like Xarelto in lei of coumadin right up to ablation, PVAI isolation techique etc....
Any questions why this man is the best in the business?

McHale

Paul, you make it sound like I had a choice to have a GA or conscious sedation. I didnt. They say how they are going to do the procedure and you say okay. Basta. It depends on the personal preference of the EP and hospital. I am definitely no braver than anyone else. I just decided to go with the flow and enjoy the ride. They can give you more or less sedation so you would actually fall asleep during the procedure if need be, you can still talk and answer questions but you have no recollection of it afterwards. Travis, it wasnt scary at all.

I asked my EP why they didnt do a GA and he explained it to me this way; among other reasons, one of the major complications of an ablation is atrial-esophageal fistula (before you get excited here this is a RARE, RARE complication, it can be fatal though so its important to do everything to avoid having it happen). Its my understanding that it can happen when burning the back of the heart, near the esophagus and then the esophagus somehow can be damaged. My EP said if you are awake you would feel that and would tell them, they would stop and no damage would be done. BUT if you are having a GA, dont worry youre covered. I believe they put something like a thermometer down your throat so they can keep a check on the temperature to make sure nothing like that happens. Different approaches to the same solution: no atrial-esophageal fistula.

McHale thats an interesting study that you quoted. I can imagine that the GA group had another advantage not only that the patient is immobile and breathing regular (of course, Id like to believe that I didnt move and my breathing was regular during my ablations) but that the EP did a bit more of an aggressive ablation when the patient was under a GA than when he/she was consciously sedated. No major complications in either group is very good. The outcomes are a bit sobering.

Take care,
atp

McHale...thanks for citing that study. I didn't see that one. Good to know Natale is on top of things:)

ATP...I hear you. Of course you didn't have a choice. It's not like you're going to walk out of the operating room...lol. I Just can't believe some perform this while the person is awake. I have a feeling my anxiety-ridden mind would over power the drugs and I'd feel and remember everything;) I've had 4 cardioversions and during one of them they supposedly put me out like they always do except I sort of felt it and to this day I remember it. It wasn't painful by any means but it was a very interesting "out of body" experience to say the least.

I'd rather be completely out. If I die, well at least I die sleeping:)

Travis