AFib ablation: What to expect
Although atrial fibrillation (AFib) is a common heart issue that affects millions of Americans, according to the Centers for Disease Control and Prevention, it’s important to seek treatment. An irregular heartbeat, known as arrhythmia, can lead to serious health complications like stroke.
If you’ve been diagnosed with AFib, your doctor may recommend AFib ablation to neutralize the part of your heart causing your irregular heartbeat. While the procedure is considered very safe, knowing what to expect beforehand can give you peace of mind.
What is AFib ablation?
AFib treatments, such as cardiac ablation for AFib, can be used as a first-line option or follow-up if other treatments aren’t effective. Ablation is a minimally invasive procedure that involves using thin, flexible tubes called catheters. These ablation catheters can deliver thermal energy (either heat – radiofrequency ablation, or cold – cryoablation) or electrical impulses (pulsed field ablation) to areas of the heart tissue that are causing or enabling atrial fibrillation. This energy creates scar tissue, which disrupts the electrical signals behind the arrhythmia. By targeting the specific area responsible, ablation helps restore and maintain a normal heart rhythm.
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What happens during an AFib ablation procedure?
During catheter ablation for AFib, your care team will put you under intravenous (IV) or general anesthesia, depending on individual factors to keep relaxed throughout your procedure. Your cardiologist —specifically an electrophysiologist, a doctor specializing in heart rhythm disorders — will begin the ablation by inserting a thin needle into a vein in your groin. They will then thread one or more catheters through the vein to your heart, using X-rays or ultrasound to guide their way through your body.
When they reach your heart, your doctor will use catheters to identify the source of the abnormal rhythm. Once they find the area, they will deliver electrical signals through the catheter tip to destroy the affected heart tissue with the ablation catheter.
Once they have successfully ablated all the areas causing AFib, your doctor will remove your catheters and close the site in your groin with sutures.
How to prepare for AFib ablation
Fortunately, AFib ablation is usually performed as an outpatient procedure, meaning most patients can go home the same day as their treatment. Since catheter ablation is minimally invasive, recovery time is significantly shorter compared to traditional open-heart surgery.
Even so, understanding what to expect before, during and after the procedure can help you feel more prepared.
Your care team will provide specific instructions regarding your anticoagulation (blood-thinning) medications, which are often continued after your procedure.
Before your procedure
After scheduling your cardiac ablation, your care team will review your medications and let you know when to stop taking them prior to procedure day. Generally, you’ll stop taking medications 3–7 days before your ablation unless told otherwise by your care team.
Here are some specific guidelines:
- Stop amiodarone seven days before your procedure.
- Stop beta blockers like metoprolol, carvedilol, propranolol, nebivolol, labetalol and bisoprolol as directed by your care team.
- Stop medications that control your heart rate, such as digoxin, and calcium channel blockers like verapamil or diltiazem, three days ahead of your procedure.
- Stop other antiarrhythmics, including flecainide, propafenone, sotalol, dofetilide or dronedarone five days before your ablation.
If you experience issues after stopping your medications — such as chest pain, shortness of breath, dizziness or a heart rate that’s consistently above 110 beats per minute — call 911 immediately or contact your doctor’s office.
Additionally, you will not be able to eat or drink anything after midnight the night before your procedure.
On procedure day
On the day of your ablation procedure, you will check in at your scheduled time and wait for your prep nurses to call you back for your treatment. Be sure to bring your insurance information and identification.
Once you’re taken back, your nurses will ask some questions to confirm your medical history and get you ready for your procedure, including starting an IV and drawing blood for lab work. You’ll also meet with your anesthesiologist and go over what to expect with your anesthesia.
For most AFib ablations, you’ll have a transesophageal echocardiogram (TEE), a special kind of screening using a probe to check for clots in your heart. If clots are found, your ablation will be canceled for safety reasons.
After you’re cleared, your care team will take you to the electrophysiology lab, where you’ll get IV sedation to help you stay relaxed throughout your procedure. Your doctor will numb the area around your groin before inserting the catheter to start your ablation.
You should not feel or remember anything during your procedure.
After your procedure
After your procedure, your nurse will take you to a recovery area to monitor your vitals and watch the insertion site for bleeding. Expect to lie still for several hours during recovery.
Once your vitals are stable, your nurse will:
- Remove your sutures, if any.
- Provide instructions on medications, which will likely include blood thinners to lower your risk of stroke.
- Review other discharge instructions with you.
Roughly 10–12 weeks after your ablation procedure, you’ll have a follow-up appointment with your cardiologist to check your heart and go over any symptoms you’ve experienced.
It’s also important to understand that AFib can return even after successful ablation surgery. Regular check-ins with your cardiologist are essential for safely managing your condition over time. And we make it easy for you to access a full spectrum of heart, lung and vascular treatments and services.
Better heart health is just a call away
As the state’s largest cardiovascular network, we make it easy for our patients to connect to heart, lung and vascular specialists close to home. Get connected with a heart doctor in the HCA Florida Healthcare network when you call our cardiovascular physician referral line at 833-544-5031.