Maureen is an active, 67-year-old with atrial fibrillation. Once every couple of months she develops an episode of shortness of breath, fatigue, and the sensation of an abnormal heartbeat. She has tried medications to treat atrial fibrillation (AFib) but these haven’t worked. She is considering atrial fibrillation surgery but is worried about the AFib ablation recovery time.
“When I am in AFib, it feels like someone has pulled the plug and all my energy drains away,” she says. “My doctor has talked to me about getting an AFib procedure to treat atrial fibrillation but I am the primary caregiver for my husband, who has advanced Parkinson’s, so I was concerned about the AFib ablation recovery time. He needs my help every time he wants to get up from his chair or get out of bed. We needed to know more about atrial fibrillation surgery and heart ablation recovery to know if an AFib procedure would even be an option for me.”
Maureen laughs, “My poor cardiologist; I brought in such a long list of questions. He probably thought the appointment would never end!”
Maureen is not alone. The decision of how to best treat atrial fibrillation can be complicated. Common questions people ask about atrial fibrillation ablation procedures and heart ablation recovery include:
How long an atrial fibrillation ablation takes depends on the type of cardiac ablation being done. Generally, the less invasive the procedure, the shorter the procedure time. Catheter ablation treats atrial fibrillation from the inside of the heart. This procedure is done via catheters which are inserted into veins in the groin and then guided up into the heart. In contrast, a Maze procedure is a surgical ablation that gains access to the heart by making incisions in the chest wall. Both of these procedures are considered to be minimally invasive. The less invasive catheter ablation usually takes about 2 hours whereas the more invasive Maze procedure for AFib may take 3 to 4 hours.
An AFib procedure is usually completed using a minimally invasive technique unless it is being done as a part of another heart surgery, such as heart valve replacement. This helps decrease procedural risks. As a result, minimally invasive AFib procedures like catheter ablation, Maze procedure, and watchman procedure for AFib have low complication rates. However, as with any invasive procedure, there are risks associated with AFib procedures including:
Cardiac ablation is done under general anesthesia. Although the medications used during general anesthesia wear off after a few hours, it is not unusual to notice fatigue and grogginess during the ablation post-op period. Usually, this resolves in the first day or two after the procedure. But for some people, the symptoms may last for a couple of weeks.
Typically, the longer you are under general anesthesia the more likely you are to have persistent grogginess post cardiac ablation. It is commonly assumed that the after-effects of anesthesia are causing these continued symptoms after cardiac ablation. But there are actually a number of contributing factors including:
The most common problems after cardiac ablation are related to bleeding at the catheter insertion site or blood vessel damage from the catheter. Therefore, people are monitored closely and often stay overnight after their AFib procedure to make sure there are no bleeding complications. Other things to expect during your heart ablation recovery include:
There is currently no cure for atrial fibrillation. The goal of atrial fibrillation ablation is to give a person a period of being free from AFib. Over the past decade, there have been a number of changes in the way we treat atrial fibrillation.
One important evolution has been improved ablation technology and techniques which have increased ablation success rates. In addition, there is a better understanding of the importance of early, aggressive management of AFib risk factors and treatment of the underlying conditions that cause AFib.
Studies show that these changes have combined to make atrial fibrillation treatment more effective and last longer. There are still people who continue to have atrial fibrillation despite AFib ablation. But we see many people go for years, and even decades, without AFib recurrence after cardiac ablation.
Atrial fibrillation originates in the left upper heart chamber (atrium) and pulmonary veins. The purpose of an atrial fibrillation ablation is to create scar tissue in the pulmonary veins and left atrium that blocks the abnormal electrical signals which cause AFib. If you have a recurrence of atrial fibrillation after heart ablation, your doctor may recommend a repeat ablation. Sometimes this is referred to as a ‘touch-up’ ablation.
If you have had 4 ablations and you continue to have recurrences of atrial fibrillation, your doctor will probably talk to you about other treatment options. This is because the after-effects of too many cardiac ablations are too much scar tissue in the left atrium and pulmonary veins. This makes them stiff which causes chronic shortness of breath and exercise intolerance.
People can usually go back to work after a few days of AFib ablation recovery time. If your job requires lifting more than 10 pounds, you will need to wait for at least a week to give time for the ablation access sites to heal.
It is normal to have some mild chest pain or pressure during the first days to weeks of AFib ablation recovery. Other than this, people generally report little or no pain after catheter ablation. AFib surgery recovery is usually longer and it is normal to have some pain for a few days after a Maze procedure for AFib. Pain after cardiac ablation is usually managed primarily with anti-inflammatory medications. Sometimes, steroids, opioids, or gabapentin are also used for a couple of days post-cardiac ablation.
After talking with her cardiologist, Maureen decided to go ahead with catheter ablation for her paroxysmal (intermittent) atrial fibrillation. It has now been 6 months since her AFib ablation. She has had no recurrences of AFib since the ablation. “After my ablation, I had to take it easy for a week, but my daughter was able to come stay with us to help with my husband and the ablation recovery ended up being no big deal,” she says. “I have felt so great since my ablation and was even able to stop some of my AFib medications a few months ago, which I was really happy about. I know I may have AFib again in the future but for the time being, I am glad to have a break from the AFib and the medications.”
