Post-discharge instructions for atrial
fibrillation ablation patients
We are providing you with these discharge instructions to help answer any questions you might have and as a guide for you until we see you in follow-up. As you know, you recently underwent an ablation for atrial fibrillation. Atrial fibrillation is a complex and potentially serious arrhythmia which, until recent years, was not curable with a minimally invasive procedure. We now have the ability to cure atrial fibrillation in many patients utilizing catheter ablation technology. You underwent this procedure because you doctor felt you could potentially be cured of this arrhythmia. Most of the other types of catheter ablations we perform have greater then a 95% cure rate and require minimal follow-up care. Atrial fibrillation ablations however require some more special post-operative care. It is important for you to read and follow these instructions to maximize your chances for cure and minimize any chances for potential problems.
1. In the first two days post-ablation you should take it easy. No heavy lifting or heavy exertion
2. Your groin will generally have two access site points, one on each side. Some minor bruising is common at each site with minor soreness as if you had banged the area. Bruising may occasionally be seen to extend down the leg. This is normal as is an occasional small quarter sized bump in the area. If larger swelling or more significant pain occurs at the area, please contact the electrophysiologist who did the procedure so we can evaluate you.
3. You may have some minor chest pain for the next week or so. The pain will often worsen with a deep breath or when leaning forward. This is pericardial chest pain from the ablation and is generally not of concern. It should resolve within a week although it might increase for a day or so after the ablation.
4. If you develop unexplained fevers exceeding 100 degrees anytime within the first 3 weeks post-ablation, you need to contact the electrophysiologist who performed your procedure. Low grade fevers of around 99 degrees are common in the first day or so post-ablation.
5. It is important to continue all medications prescribed including anticoagulation therapy until instructed otherwise. Anti-arrhythmic drug therapy will often times also be continued or is occasionally initiated to help your heart heal from the ablation. Your doctor and the nurse practitioners will review your medications prior to discharge.
6. Patients will occasionally be asked to check their coumadin levels more frequently in the first few weeks post-ablation; If you are asked to do so, please remember for your own good to have this done.
7. Arial fibrillation can reoccur in all patients who undergo this ablation for up to 4 weeks post-ablation. The ablation itself can cause inflammation (pericarditis) in the atria and this can cause atrial fibrillation. Some patients will actually experience an increased density of atrial fibrillation early after ablation. Approximately 1/3 of patients will have this early reoccurrence of atrial fibrillation. Medications should be continued and your heart rate controlled. Nothing else need be done initially except waiting as in many cases these episodes of atrial fibrillation will prove self limited.
8. Other arrhythmias mimicking atrial flutter can occasionally be seen in the post-ablation phase. Most of these arrhythmias will prove to be something called “left atrial macroreentry tachycardia”. As with post-ablation atrial fibrillation, in many patients these problems will prove to be self limited but can sometimes last 2 to 3 months. Again, the heart rate needs to be controlled with medications until this arrhythmia resolves.
9. In approximately 30% of patients, post-ablation arrhythmias do not resolve with waiting. In these patients, a repeat ablation could be considered after a period of waiting of 2 to 3 months to be sure that spontaneous resolution of the post-ablation arrhythmia has not occurred.
10. Please be certain to make a follow-up appointment with the doctor who performed your ablation 8 weeks from today. It is important we see you in follow-up. If you are doing well, the doctor will likely start weaning the medications you had been taking for your arrhythmia.
These instructions have been posted to our web site at www.heartrhythmcenter.com. Please remember to be patient with your arrhythmia. Remember, atrial fibrillation generally reoccurs for life if left untreated. Today we can fix the vast majority of patients with paroxysmal fibrillation but this sometimes requires patients to be patient.
Thank you for entrusting us to care for you.