What happens after the procedure?
After the procedure you will wake up in a hospital ward called the recovery area. When you are completely awake you will be transferred to the normal hospital ward. You will have to lie flat for approximately 6 hours after the procedure. During this time, it is important to keep your legs straight and your head relaxed on the pillow. You will have a compression clamp on the groin area which stays in place for 4-6 hours. You will also have a urinary catheter which will be removed later that evening or the next morning. It is usual to stay in hospital for 2 nights after the procedure.
Your heart rhythm may be monitored during this time. During this time you will either continue warfarin or commence blood thinning injections. If you are taking Pradaxa, Xarelto or Eliquis, these will be restarted on the day you go home.
It is common to have a sore throat and some mild chest discomfort after the procedure. You will also have some discomfort and bruising in the groin (and neck area in the occasional case when the neck vein is required) after the procedure. This should usually improve over several days. Because it takes several weeks for the areas of ablation to heal and form scars, it is not uncommon to experience abnormal or irregular heart beat or rhythm for up to 4 weeks after the procedure.
Rarely, atrial fibrillation may be worse for a few weeks after the procedure due to inflammation where the ablation was performed. The majority of patients have approximately 1-2 weeks away from work. After you go home, you will have an appointment for review with the consultant cardiologist who performed the procedure in the following 4-8 weeks.
What is the success rate of the procedure?
This depends on the type of atrial fibrillation that you have.
Paroxysmal atrial fibrillation starts and stops by itself within 7 days.
The success rate for this type of atrial fibrillation is approximately 80-85%. This can vary slightly according to the type of heart problem that you have. In approximately 20-30% of patients it is necessary to perform a second procedure if the first was not successful. Even after 2 procedures, approximately 15% of patients will continue to have problems.
Persistent atrial fibrillation continues for more than 7 days or doesn’t ever stop without a DC shock (cardioversion). The success rate for this type of atrial fibrillation is approximately 70%. This can vary slightly according to the type of heart problem that you have. In approximately 20-30% of patients it is necessary to perform a second procedure if the first was not successful. Even after 2 procedures, approximately 30% of patients will continue to have problems. If your atrial fibrillation has been continuous for more than a year, the success rate may be lower. This will be discussed with you.
We will not know for certain whether the procedure has been successful for several months afterwards. During this time it is usually necessary to continue taking medications