I'm waiting for the ablation procedure

The principle of catheter-based radiofrequency ablation lies in the controlled application of radiofrequency energy to unwanted conduction pathways in the heart, or to areas from which an undesirable electrical signal originates. This energy destroys the tissue at the targeted site, rendering it non-conductive, so that the electrical impulses in the heart can once again propagate along the correct pathways.

During this non-surgical procedure, the physician—an electrophysiologist—introduces catheters, usually through an incision in the groin or the arm, and advances them to the heart. The catheters are guided under X-ray imaging. Throughout the procedure, the patient is monitored under local anesthesia and remains conscious; in some cases, it may be necessary to place the patient under general anesthesia.

• pounding sensation, jumping in the chest
• dizziness and fainting
• shortness of breath
• chest pain

During the procedure, the physician—an electrophysiologist—and the attending healthcare staff use state-of-the-art imaging and monitoring systems that allow them to track the precise movement of the catheters, determine the exact ablation site, and evaluate the effectiveness of the ablation. The movement of the catheters within the body and the heart itself is painless; however, the insertion of the catheters may be uncomfortable. In some cases, the patient may experience pain during the application of radiofrequency energy in the heart. If this occurs, inform the physician so that pain-relieving medication can be administered. As the ablation procedure may sometimes last several hours, be sure to inform the physician about any discomfort you experience (such as back pain from prolonged lying, etc.).

• An increased risk of the formation or release of a blood clot. For this reason, blood coagulation is continuously monitored, and the patient is given blood-thinning medication before and during the procedure.
• In rare cases, an infection may occur after the procedure.
• Damage to or perforation of the heart wall by the catheter, followed by bleeding into the pericardium. In cases of significant bleeding, pericardial drainage or surgical closure of the injury may be required. To minimize this risk, echocardiography, X-ray imaging, catheters with contact-force measurement on the heart wall, and other techniques are used.
• Bleeding around the catheter insertion site or possible damage to the vessel at the puncture site. In most cases, these injuries heal without the need for further intervention. Surgical treatment is required only exceptionally.
• Induction of another undesirable cardiac arrhythmia during certain stimulation maneuvers. Such an arrhythmia is terminated by pacing through the inserted catheters, medication, or a defibrillation shock (cardioversion) under brief general anesthesia.
• Effects associated with X-ray radiation to which the patient is exposed during the procedure. Nowadays, however, the radiation dose is very precisely monitored, and an experienced electrophysiologist uses the minimum necessary amount of X-ray radiation during the procedure.