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 a Convergent Ablation?

A Convergent Ablation is a minimally-invasive procedure that is for patients with persistent or difficult–to-treat atrial fibrillation (A-fib). A-fib is caused by abnormal electrical signals in your heart. The procedure is performed by both a cardiac surgeon and electrophysiologist. The cardiac surgeon makes three small abdominal incisions and then is able to send a video-scope and catheter to the back of your heart. The surgeon is able to ablate (or create small scars) on the back of your heart in order to stop the electrical activity causing your A-fib. Once the surgeon completes the ablation on the outside of you heart, the electrophysiologist sends a catheter inside your heart. The electrophysiologist ablates the signals coming from inside your heart (around the pulmonary veins) causing the A-fib.

Why is this procedure being done?

A hybrid ablation is a treatment option for people who:

  • Have taken medication to treat their abnormal heart rhythm without success
  • Cannot tolerate the cardiac medications because of the side effects
  • Have persistent A-fib even after mediation, cardioversions, and previous ablations

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 assisted on 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 our primary concern. A sterile drape will be used to cover your groin site to prevent infection. You will be under general anesthesia during the entire case. There will be three small incisions on your chest and small puncture sites to both your groins. Once the doctor has access to your heart, they will begin to ablate the areas of your heart.

The energy used in your procedure can come from:

  • Heat (Radiofrequency)
  • Extreme Cold (Cryoablation)

The cardiac ablation may take 6-8 hours. The more complicated cases can take more than 8 hours.

After the Procedure:

Following your procedure you will be moved to the recovery area, where your chest and groin area will be monitored. You will have sheaths (large IVs) in your groin and a small drain from one of the incisions in your chest. Once it is safe, the nurse will remove the sheaths from your groin and will apply manual pressure on your groin to help the sites close and heal. A sterile dressing 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 leg straight,and not to sit up or lift your head to help reduce your risk of bleeding. Should you have increasedpain, numbness or tingling to your toes and feet, and a warm sensation like you have wet the bed,please call your nurse immediately. The drain in your chest will be removed the following day by the doctor at the bedside.

Procedural Risks:

  • Bleeding at the site where the catheter was inserted
  • Puncture of your heart
  • Damage to your heart valves
  • Stroke or Heart Attack
  • Kidney Damage
  • 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.

Seek Care Immediately/Dial 911 If:

  • Sharp 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 groin and chest dressing clean and dry for 24 hours after the procedure. After 24 hours, you may remove the dressing and shower normally. DO NOT sit in a hot tub, whirlpool, swimming pool, or bathtub for 7 days.
  • Refrain from using bandaids, powders, lotions or creams on the puncture/incision site.
  • It is normal at the puncture/incision sites to have a small amount of bruising and 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 30 days.
  • If you need to cough, laugh, sneeze, or have a bowel movement, hold pressure on your groin site. DO NOT strain or bear down.

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!