I have had a lot of atrial fibrillation and have had my heart restarted at least six times this year (DC-conversion). Monday I’m going to the hospital to get cardiac ablation, which hopefully will either cure me or at least alleviate the symptoms.
What is your experience? Was it painful? Was it worth it? How soon could you start work?
I had one about 13 years ago. It was for atrial flutter, not fib, so I don’t know if that made things simpler. I don’t remember any pain afterwards, and I think I went back to work the next day, or maybe the day after. I haven’t had any symptoms since then. I do remember I had a humongous purple bruise on my thigh that took a while to go away.
Had one in August 2022 for ventricular tachycardia. The actual procedure took about 2 hours. I spent 3 hours post op flat on my back. No pain. It really was nothing considering wires were threaded into my heart and zapped with electricity. I woke up a bit during the procedure and asked “are you done yet?” It felt like a bad case of heart burn, which it was! Went back to sleep and woke up in recovery.
Ablation for a fib is longer and more intensive. The wires go through the femoral artery. You have to lie still post op for longer. A friend had it done years ago and was house bound for a few days. I retired before the procedure but I will say the next few days I was tired and napped a lot. No lifting over 5 pounds for at least 2 weeks.
I am so glad I had it done. Sometimes my heart will flutter like it wants to go into tachy but it can’t. Success!
They tell me that the procedure will take 2 to 3 hours, after that I will have to stay on my back for at least two hours and stay under observation (electronic) for 4 to 6 hours.
They are trying a new procedure called pulsed frequency ablation ,PFA , which should have fewer risks. I’m a bit nervous, but getting a reset of the heart several times a month for the rest of my life isn’t to be thought of.
At least the hospital is the best in Denmark and I had to wait 3 months to get in.
(And it is free, of course.)
I had 4 chemical conversions before the ablation. Follow physician’s orders and don’t be in a rush to return to work.
Not exactly a reply to the OP, but I have been threatened by my cardiologist with ablation as if it were punishment. I had an episode of atrial flutter last year, resolved with what they called “cardioversion” which is probably the same as the OP’s DC conversion, i.e. an electrical shock of some kind to the heart muscle. “If it happens again” apparently another cardioversion doesn’t seem to be on the table (I’ll have to ask why not at my next follow-up appointment) and they’ll go straight to ablation. Anyway, I am pleased to read these descriptions of the procedure and its aftermath.
My cardiologist is focused on my weight as a likely cause of the atrial flutter, and possibly (although she did not say so, I wish doctors would be more direct about these things) my weight also adds risk to the ablation procedure. I shall have to ask about that as well.
I tried to look this up; it seems that PFA stands for Pulsed Field Ablation. This is a new procedure for fibrillation and flutter, the American College of Cardiologists article on it was from March.
Quite new, “Rigshospitalet” has been trying it out since October.
I probably misremembered the meaning of the acronym.
I can’t see why you can’t have the electric shock more than once. It’s a nuisance, but certainly better than going around with a pulse of more than 160.
My step dad had one maybe seven years ago when he was in his early 80s. He came through it fine. He’s turning 90 soon and is going strong with no problems
I had a successful cardio ablation for AFIB about 5 years ago. I feared and dreaded the procedure, but actually found the experience fairly easy and would not hesitate to do it again if necessary.
Here’s my experience: You’ll start by being prepped with an IV, have ECG sensors attached, and someone will shave your inner thigh so they can cleanly access your femoral artery (you might want to shave yourself ahead of time). They may want to insert a catheter so make sure they do that AFTER you have been put under, but I think that’s normal procedure anyway. Then they’ll wheel you into the procedure room which will be an extremely high tech and very cold environment. They’ll give you a welcome warm blanket and the anesthetist will make some comment about here we go. Next, you’ll wake up in recovery and you’ll be told to keep your leg still to let the incision in your thigh heal somewhat. Since you would have been on anticoagulants it takes awhile for the incision to heal. Five years ago it was typical to spend the night in the hospital, but I’ve been told they learned during Covid that they can safely discharge the same day and people generally prefer it. The only problem I had overall was that my femoral nerve got irritated at the incision site and I had an intense burning sensation for about a week whenever I walked. Otherwise, it all went well. My only regret is that I waited as long as I did.
From what I’ve learned the most important thing about a cardiac ablation is the experience of the EP. There’s a Medicare website some place that lists the ablations/year for all the EP’s that submit claims. Get someone who does several hundred/year.
Good luck with your procedure.
I had been diagnosed with tachycardia and A-fib last year, and they decided to do an ablation. I was told the same things you were about the procedure and follow-up; I was scheduled for early in the day and I was told there was a chance I would be sent home that evening. The procedure itself went well, but I had a complication which you probably don’t have to worry about. I’ve been suffering from anemia for years, and apparently having been on Eliquis since the A-fib diagnosis caused my iron levels to nose-dive. So they kept me overnight to give me an iron infusion, and I had to be scheduled for further infusions over the next month. They also took me off the Eliquis.
The good news, however, is that I haven’t had an A-fib incident since the ablation. The only follow-up they’ve done was the installation of a Watchman device this past March. This was to prevent possible clotting due to having to take me off the Eliquis. Having multiple conflicting conditions is fun.
If you’re bored, and eager to distract yourself before the procedure, I’m a forum member over here:
Lots of kind and supportive people with lots of experience and good information.
The general site is also quite helpful:
Held og lykke!
(Good luck!)
A cardiac ablation is just about the only procedure that has not been recommended to me. I used to go to my “old country doctor” who has since retired and closed his practice. Each year I would go in for an appointment to renew my blood pressure meds and he would tell me, “you know you have extra heart beats, does it bother you? No” See you next year.
Two years ago I asked him if my meds were working because I was feeling different. He said it was probably atrial fibrillation but he wanted an EKG before he prescribed some Metoprolol. His EKG machine was broken so he sent me over the hospital and they would do a walk-in EKG.
The hospital took one look at my EKG and told me to go downstairs, turn left, and go into the big sign that said EMERGENCY. They kept me for 3 days, charged me $8000 just for room and board. The full bill was much larger. I had one sandwich and watched shitty reruns of Bonanza. Because the A-fib has been so long term they were reluctant to stop and restart my heart, that would usually be done. Since then and after many procedures, I still feel mostly normal but am told that I am in danger of imminent sudden death. Permanent, persistent, atrial fibrillation, going on for years. I just thought this was the way everyone’s heart felt.
My blood pressure is under control, blood thinner level is where it should be, water retention is no longer an issue, 66 years old. And I feel fine, as I always have. I swing a weed-eater, mow the lawn, seem physical fit, am not overweight. Losartan, Metoprolol, Torsemide, Spironolactone, Jantoven, and Digoxin. I feel fine, really.
The next procedure will be a myocardial perfusion study with radioactive dye. I can hardly wait. I told my cardiologist that I am taking the summer off from these tests and we will do it in September. If that shows nothing that can be fixed I may be referred for a cardiac implanted defibrillator. Kind of like having an EMT implanted in your chest that will shock you if your heart fails.
And I am under the care of OHSU, Oregon Health Science University. The best in the NorthWest.
I’ve had atrial fib for around 18 years. I feel nothing from it. I got a pacemaker nearly 16 years ago (replaced last year).
My daughter is a scientific copy editor and she sent me this abstract of a paper that appeared late last fall.
“Calcitonin, known as a thyroid-secreted hormone involved in calcium and bone metabolism, is also secreted by cardiac tissue, where it acts as a paracrine signal promoting atrial fibrosis and atrial fibrillation.”
As the authors don’t fail to point out, this suggests that reducing calcitonin levels might be a viable strategy to treat atrial fibrillation, and closer to its root causes than the anti-clotting agents do. Interestingly, there are calcitonin-reducing drugs already on the market for migraine (its function is actually somewhat obscure and appears to be mostly redundant with those of other hormones, but it has some role in migraines). This might or might not reverse existing “atrial fibrosis” (hardening of the atrial tissue) that contributes to atrial fibrillation, although if the fibrosis process is remotely like bone growth, it might over time (bone growth involves basically an equilibrium between hardening and softening). Probably won’t arise anytime soon, but it’s interesting. And any drug that gets approved for migraine is probably on the safer side (as far as is known) since migraine is generally not life threatening and there are other drugs to treat it.
Not sure how relevant this is to your situation:
I had a cardiac alcohol ablation a bit over a year ago, for a mitral valve blockage caused by asymmetrical septal hypertrophy. So that’s a cardiac ablation, but I gather a different procedure, and for a different condition.
Get to the hospital very early in the morning. Take off clothes, put on hospital gown, have large young man announce that he’s going to shave my pubic hair. Given sedative/anaesthetic, went unconscious. Woke up with somebody leaning very hard on my groin trying (successfully) to stop bleeding from where they put the tubes in my groin that went up to my heart.
They kept me there two days, because that procedure sometimes causes heart block – they burn off some of the overgrown thickness of the heart, but the nerves that tell your heart to beat run through there. They thought they’d saved the nerves and I wouldn’t need a pacemaker, but late on the second day my heart started skipping beats and they said yes I did; they put the pacemaker in first thing the next morning and sent me home late that same morning.
I had pain from the large bruise in my groin and pain from the pacemaker insertion site, but none from the ablation itself; and not enough pain from anything that I couldn’t handle it without meds; especially since they only offered me Tylenol, which doesn’t do anything to me anyway. I don’t know whether I could have gotten something stronger if I’d tried, but it didn’t seem necessary.
The friend who drove me there and back stayed with me at home for the first week. I wasn’t supposed to lift anything heavy or to raise my left arm above my shoulder for six weeks; but that was due to the pacemaker, not directly due to the ablation. I did feel very weak and sleepy for some days, and the weakness went off gradually.
To the Op. Was your heart scanned for blood clots? Afib can trigger those and they can break off and cause serious/fatal problems.
Yes, a CT-scan friday and a lot of blood tests. I have been on bloodthinners the last year, Eliquis, so I think I’m good.
Yes, for Wolff-Parkinson-White syndrome.
I had to go in twice. The first time, they somehow wrapped one of the valve strings around the tip of the catheter, and couldn’t remove it. They eventually employed a few tricks and got it pulled out, but didn’t finish the procedure. I stayed at the hospital overnight and was working the next week (I had it done on a Thursday).
Second time went smoothly. Still stayed at the hospital overnight, and was back at work after a few days.
It fixed the problem completely. And really not a big deal, IMO. No pain at any point. I did find it interesting to watch the catheter thread into me on their x-ray monitors.
As I had mentioned, when I had my ablation they ended up keeping me in the hospital for reasons not related directly to the ablation procedure. One side effect of this was that while I was there they kept checking on the status of the insertion site to make sure it was healing properly (instead of me having to do it at home). I later joked to a friend that in the last week I’ve had more people looking at my naked groin then have done so in the past five years.
Well, now is the day. I’ll report back later today or tomorrow. Wish me luck 
Thank you for your stories. They helped a lot.
Best of luck, @Mikkel !!