Thank you for choosing Rose Medical Center for your cardiac care. Our goal is to make your stay as comfortable and pleasant as possible. Please let our knowledgeable and friendly staff know if there is anything we can do to improve your experience.

What is Atrial Fibrillation?

Atrial fibrillation is the most common type of irregular heartbeat (arrhythmia). Normally, the heart beats in a strong and steady rhythm. In atrial fibrillation, a problem with the heart’s electrical system causes the two upper parts of the heart, the atria, to quiver or fibrillate. This is dangerous because if the heartbeat isn’t strong and steady, blood can collect or pool in the atria. Pooled blood is more likely to form clots. Clots can travel to the brain, block blood flow and cause a stroke.

What causes atrial fibrillation?

There is no one cause of atrial fibrillation, although it is associated with many conditions including:

  • Hypertension
  • Coronary artery disease
  • Heart valve disease
  • Sleep apnea
  • Heart failure
  • Cardiomyopathy
  • Pulmonary embolism
  • Congenital heart disease

Less common causes include:

  • Hyperthyroidism
  • Pericarditis
  • Viral infection

What are the symptoms?

Symptoms may include:

  • Feeling dizzy or lightheaded
  • Feeling like your heart is fluttering, racing, or pounding
  • Feeling out of breath
  • Having chest pain (angina)
  • Feeling weak and tired
  • Fainting

How is atrial fibrillation treated?

Your treatment will depend on the causes of your atrial fibrillation, your symptoms and your risk for stroke. Medications are an important part of treatment and they can include blood thinners, rate-control medications, and/or rhythm-control medications. Doctors also sometimes use a procedure called a cardioversion to try to get the heartbeat back to normal. If your symptoms do not respond to other forms of treatment or continue to bother you an ablation may help. The ablation destroys small areas of abnormal heart tissue. The scar tissue formed blocks or destroys the areas that are causing the abnormal heart rhythm.

Before the Procedure:

You will be asked not to eat or drink anything after midnight the night before the procedure. Discuss your medications with your doctor, as he or she may want you to stop or adjust the doses several days prior to your procedure. Please bring all your current medications in their original bottles with you on the day of your procedure. Please bring a list of all drug/food allergies, past medical and surgical history also with you. We recommend that you wear comfortable clothing and bring a small bag with your personal items and toiletries in the event you spend the night in the hospital to make your stay as comfortable as possible.

What to Expect Upon Arrival to the Hospital:

When you arrive for your procedure, you will be asked to change into a gown. Please remove all undergarments and use the restroom as needed. Please let the staff know if you are taking blood thinners such as Aspirin, Coumadin, Plavix (clopidogrel), Effient (prasurgel), Brilinta (ticagrelor), Xarelto (rivaroxaban), Eliquis (apixaban), and Pradaxa (dabigatran etexilate), diuretics (water pills), and/or any form of diabetic medication. An IV will be started so you can receive medications during your procedure and the nurse will review your medical history with you once again. At this time blood work will be drawn if needed and an EKG will be performed.

During the Procedure:

The temperature in our catheterization lab is kept cool to prevent damage to our x-ray equipment that is used during your procedure. We will offer you warmed blankets for your comfort. You will be assistedon to a special table for the procedure and then we will begin attaching monitoring equipment to you.

The cardiac cath lab staff will shave and cleanse your groin while keeping your privacy as ourprimary concern. A sterile drape will be used to cover your groin site to prevent infection. It will be important for you to keep your arms and hands down at your sides during the procedure.

Depending on what type of procedure you are having, your doctor will discuss which type of anesthesia you will be given. For shorter procedures, you will be given medications to help you relax, also known as twilight sedation, but you may be awake during the procedure so we can ask questions and assess your comfort. During longer ablation procedures you will be receiving general anesthesia during the entire case. For these procedures you will be asleep the entire case. These options will be discussed between you and your doctor.

A local anesthetic will be given by the physician to numb the procedural site and aid in your comfort. Sheaths (large IV’s) will be placed in your groin and catheters (long flexible tubes) will be advanced to your heart and the doctor will begin gathering information about your abnormal heart rhythm. Once the abnormal rhythm is found, we will use the catheters to send energy to the area that is causing the arrhythmia.

The energy used in your procedure can come from:

  • Heat (Radiofrequency)
  • Extreme Cold (Cryoablation)

The cardiac ablation may take 2-6 hours, depending on your arrhythmia and the type of anesthesia you will be receiving.

After the Procedure:

Following your procedure you will be moved to the recovery area, where your groin area and the remaining sheaths (large IVs) will be monitored. Once it is safe, the nurse will remove the sheaths from your groin.

The nurse will apply manual pressure on your groin to help the site close and heal. A steriledressing will be placed on the groin site to protect you from infection and the site will be observed for signs of bleeding frequently by your nurse for the next several hours.

You will be on bedrest for the next 4 to 6 hours where you will be asked to lie flat, keep the affected legs straight, and not to sit up or lift your head to help reduce your risk of bleeding. Should you have increased pain, numbness or tingling to your toes and feet, and a warm sensation like you have wet the bed, please call your nurse immediately.

Procedural Risks:

  • Bleeding at the site where the catheter was inserted
  • Puncture of your heart
  • Damage to your heart valves
  • Stroke or Heart Attack
  • Infection
  • Blood clots in the legs, lungs or brain
  • Fluid around the heart (cardiac tamponade)
  • Esophageal atrial fistula (a connection that forms between your esophagus and part of your heart)
  • Phrenic Nerve damage

Contact Your Doctor If:

  • Fever greater than 101 and/or chills
  • Redness, swelling, tenderness, and pus-like drainage from the puncture site
  • You have problems taking or obtaining any of your heart medications

Possible Post Ablation Symptoms:

  • Moderate chest pain worse with movement or inspiration similar to pericarditis
  • A mild cough that is non-productive is normal
  • Some bruising underneath the skin at the puncture sites

Seek Care Immediately/Dial 911 If:

  • Severe Chest pain that becomes worse with deep breathing
  • Increased shortness of breath
  • Bleeding or swelling from your groin site
  • New and/or severe lower back pain (different from chronic back pain you may have)
  • Coughing up blood
  • Your leg below the puncture site changes color, becomes numb, or is cool to touch
  • You have feelings of dizziness, extreme fatigue, or fainting spells

Follow Up and Discharge Instructions:

  • Keep your dressing clean and dry for 24 hours after the procedure. After 24 hours, you may remove the dressing and shower normally. It is not recommended that you sit in a hot tub, whirlpool, swimming pool, or bathtub for 7 days.
  • Refrain from using bandaids, powders, lotions or creams on the puncture site.
  • It is normal at the puncture site to have a small amount of bruising and a pea to marble sized firm area underneath the skin along with some tenderness.
  • Wear comfortable and loose-fitting clothes for the first 3 days following the procedure.
  • Ask your doctor when it is safe to return to work and drive.
  • Ask your doctor when it safe to resume sexual activity.
  • Do NOT lift, push, or pull heavy objects (more than 10 pounds) for the first 7 days.
  • If you need to cough, laugh, sneeze, or have a bowel movement, hold pressure on incision site. Do NOT strain or bear down.

*Although cardiac ablation can be successful, a minority of people need repeat procedures. You may also need to continue taking medications, even after you’ve have had an ablation as determined by your doctor. Your doctor will discuss all home medications with your prior to leaving the hospital.

References

If you have any further questions before your procedure please call the office and speak with your physician.

Thank You For Choosing Rose Medical Center For Your Cardiac Care!