Through these tests, your doctor will discuss the appropriate treatment plan for you and further determine whether you are an appropriate candidate for this procedure. You and your family will be informed of the specific medical plan.
Risks
Transcatheter radiofrequency ablation of atrial fibrillation is generally safe. However, as with some other invasive procedures, there are some risks. However, the surgeon will do his or her best to be responsible and take precautions to minimize the risks of the procedure.
Success rate
A successful catheter ablation procedure is defined as a patient with atrial fibrillation who recovers and maintains sinus rhythm and no longer requires any medication to control the rhythm. The primary success rate of catheter radiofrequency ablation for paroxysmal atrial fibrillation at our center is 70-85%.
Preoperative considerations
Preoperative atrial fibrillation lasting for more than 24 hours and prolonged atrial tonus can easily form thrombus in the atria, so preoperative esophageal ultrasound (TEE) should be routinely performed to check for thrombus formation. And other heart diseases such as congenital heart diseases should be excluded.
Preoperative medication
Warfarin and antiarrhythmic drugs are usually discontinued preoperatively.
Do not discontinue any medications on your own unless you have informed your primary care physician of your condition so that he can help you make a decision.
What should I expect?
You may eat and drink normally the night before the procedure begins. However, please avoid eating and drinking water or chewing other foods after 12:00 midnight, mainly gum, mint, etc. If you must drink water because of medication, try to take only small sips of water. Avoid swallowing large amounts of water when brushing your teeth.
Dressing
Please refrain from wearing makeup and nail polish before admission. Wear comfortable casual clothes. We will change your uniform after admission (reason). Please leave your jewelry (including wedding rings and watches) and other valuable items at home. Any other items you bring with you can be left in your locker.
What to bring before the procedure
Bring any prescribed medications you were taking, but it is best to ask your primary care physician to direct you to take them according to your specific condition after consulting with him. You can also listen to soft music to ease your anxiety before surgery.
At the beginning of the procedure, the nurse will establish intravenous access for you, primarily to administer fluids or medications during the procedure.
We will administer intravenous sedation, which will put you to sleep quickly and in a state of deep sedation, and we will perform routine disinfection and draping (neck, chest, arms and groin area will be disinfected) in preparation for surgery.
Where is the surgery performed
The procedure is performed in the catheterization room
Monitoring facilities
The patient’s heart rate and rhythm will be monitored intraoperatively with monitors that will be used to monitor
How the catheter is delivered to the heart
Once you are under deep sedation, the femoral and subclavian veins are punctured and the catheter is delivered through these puncture points to the heart where radiofrequency energy is delivered through other devices to perform the ablation. The cardiac reconstruction and pulmonary venous flow can also be observed through a monitoring system.
catheter through the peripheral veins first into the right atrium and then through the puncture needle to the left atrium.
When the catheter is ready, the physician observes the conduction pathway of the heart through a monitor and then dispenses radiofrequency energy to isolate abnormal excitation in the pulmonary veins, thereby blocking the onset of atrial fibrillation
when the ablation is complete, the electrophysiologist will; will observe the electrical signals within the heart through the device.
How the patient feels during the ablation process
You will be deeply sedated at all times during the ablation procedure and may feel a burning sensation at first.
You may experience a slight discomfort or burning sensation in the chest during the delivery of radiofrequency energy. During the procedure, you should remain quiet, keep your feet still, and avoid deep breathing. If you experience pain during the procedure, you should have your doctor or nurse administer the appropriate medication.
How long will the procedure last?
The procedure will last 3 to 5 hours.
The physician will remove the catheter and apply pressure to the puncture site to prevent bleeding. The puncture site will not require sutures, only a bandage.
After the procedure, the surgeon will inform the patient and family about the procedure and the results.
What you will feel after the surgery
You may experience weakness and chest discomfort for 48 hours after surgery. If the symptoms are significantly worse or last for a long time, please inform your primary care physician, who will treat the symptoms according to the specific situation.
How long do you need to stay after surgery and how to manage yourself
Post-operative braking for 6-8 hours.
Anticoagulants such as warfarin to prevent thromboembolism are required for the first three months postoperatively. The INR (an indicator to assess the amount of warfarin) should be monitored frequently to keep it within the appropriate anticoagulation strength. Anti-arrhythmic drugs should be continued for about two or three months after surgery.
Arrhythmias may still occur for up to three months after surgery, so you should continue to take anti-arrhythmic drugs for about two to three months after surgery to counteract and, if necessary, resuscitate them.
After surgery, your family should accompany you home without prolonged bed rest, and you can do appropriate activities to help restore your body’s function (e.g., short walks).
Precautions after returning home
Do not swim for five days after returning home. Take a shower as much as possible and avoid bathing. Keep the puncture site clean and dry.
Normal activity is usually possible 48 hours after surgery, but lifting more than 10 pounds should be avoided for one week
You may still feel palpitations or even short bouts of atrial fibrillation for up to three months after surgery. This is normal due to the presence of postoperative stuttering in the atrial muscles and is likely to return when the heart function has fully recovered.