Is Catheter Ablation Surgery right for you? My personal story may help you decide

I had Catheter Ablation Surgery about 9 months ago on Valentine’s Day. (That’s right, a heart operation on Valentine’s Day). It worked for me and stopped my chronic AFib episodes.  I am very nervous about saying that, since I don’t want to jinx anything by actually proclaiming victory. Statistics show that only about 50% of people have their AFib cured with one Catheter Ablation Surgery, and there is an 80% cure rate for those who undergo 2 surgeries. Here are some facts and pointers from the patient’s point of view that may help you decide whether or not to have Catheter Ablation Surgery. I am NOT a doctor, so what I am giving you is a personal view from my side of the operating table. If you are having AFib issues make sure to get medical advice from a real doctor.

Detail of Catheter Ablation surgery.

Detail of Catheter Ablation surgery.

Having chronic AFIB does not mean you did anything wrong. Like many people with AFib I was annoyed that my heart had decided to betray me. After all, I had given my heart everything it could desire. I have never smoked, I don’t drink alcohol, I am thin and I exercise regularly. I even gave up caffeine and everything with high sodium. Still, my heart would periodically go into prolonged AFib. If you have ever had one of these episodes, you know how frightening they are. It feels like you are dying from a heart attack.

The catheter is inserted in the groin and sent through the veins into the heart

The catheter is inserted in the groin and sent through the veins into the heart

The older you get the more frequent AFib becomes. I never had a problem until I was about 50. Then I had my first AFib episode. It only lasted about a minute but it scared the Hell out of me. As I continued to age, the episodes became more frequent and longer.

There are many excellent medications that can control AFib but the success rate varies tremendously between people. For some people the medications work just fine and they never even have to consider Cather Ablation Surgery. For me, the medications worked for a few years and then became less and less effective as I got older. Eventually they did not work at all.

Gagnon Cardiovascular Institute, Morristown New Jersey

Gagnon Cardiovascular Institute, Morristown New Jersey

AFib often happens when you are just relaxing or even sleeping. The times your heart goes into AFIb seems counter-intuitive. Most people assume that heart problems will occur when the heart is under stress. For people with chronic AFIB it is often just the opposite. I would run 6 miles and feel great. Then I might be relaxing watching T.V. and my heart would suddenly start going crazy, by speeding up and beating irregularly. It is sort of like a car with a bad transmission. The worst AFib episodes would happen when my body was trying to “change gears” from regular mode to relaxed or sleeping mode.  I finally decided to have Catheter Ablation Surgery when it became impossible for me to sleep. I got to the point where just lying flat would send my heart into AFib. I would have to walk around the house or watch T.V. until my heart went back to normal rhythm. Then I would try to go to sleep sitting upright in a chair. Over the months, I got to know exactly what television shows were on at 3AM.

Chronic AFib is caused by bad electric signals coming from the wrong part of the heart. For reasons unknown, some people have hearts that have a tendency to develop spots that send out these errant signals. If you have this condition, as you get older your heart develops more and more of these areas.  Exercise, diet or even meditation is not going to stop this from happening.

Because it is a physical condition, you can’t “think” AFib away. If you have chronic AFib, then you have probably also encountered numerous well-meaning friends giving you all sorts of advice on how to relax. They think this will cure you. Friends never seem to understand that it is precisely when chronic AFib suffers are the most relaxed that the  heart is most likely to go into one of its crazy episodes.

Doctor Timothy Mahoney

Doctor Timothy Mahoney

In Catheter Ablation Surgery the Electrophysiologist locates and burns the spots causing the bad electrical signals. Once these burns scar over,  the errant  signals stop. The first time I heard that it petrified me. “Scarring my heart to make it better?” It sounded to me like when brain surgeons of the last century  thought a lobotomy was the solution to help the mentally disturbed. This is why I would not even consider Catheter Ablation Surgery for many years. However, as I read more and more about the operation and the success rates I began to have more trust.

You still have to eat healthy after Catheter Ablation surgery

You still have to eat healthy after Catheter Ablation surgery

With chronic AFib, you need  to face your own lack of knowledge. I am NOT a doctor and I had an excellent Cardiologist and Electrophysiologist telling me that Catheter Ablation Surgery was the best possibility for fixing my condition. I looked at their years of education, training, surgical experience and skills and had to admit that they knew many, many things that I did not. I finally realized that I could do no more on my own. I decided it was time to trust these experts to put me to sleep and go into my heart.

Choosing the right surgeon and hospital for Cather Ablation Surgery is very important. You want a doctor and an institute that specializes in the field.  I was lucky enough to get Doctor Timothy Mahoney (Cardiology, Electrophysiology) at the Morristown New Jersey Medical Center Gagnon Cardiovascular Institute. He performs 2 Catheter Ablation Surgeries per day. The Gagnon Cardiovascular Institute itself is amazing. It is brand new and the lobby looks like a luxury hotel. It has the best equipment, technicians and surgeons.  Wherever you live, make sure that you choose a surgeon and a hospital that does a lot of Catheter Ablation Surgeries.

You will have to go through many tests and procedures in the weeks BEFORE your Catheter Ablation surgery. This is to make sure that you are healthy enough for surgery and that there are no other issues with your heart which will cause problems. When I went for tests, there was one patient who unfortunately was told that his heart muscles were so weak that he could not possibly  be the candidate for any type of heart surgery.

Surgeons call Catheter Ablation surgery “non-invasive”, but that’s not how it feels from the patient’s point of view. If this is “non-invasive”, then all I can say is that I feel sorry for people who have actual invasive surgery.  The surgeon  makes 2 incisions in the groin, and feeds catheters all the way from your groin into your heart. Of course, you are asleep for all of this, so it is not as scary as it sounds.

Catheter Ablation Surgery takes between 3 to 5 hours. It is a long surgery but you have no sense of time when it happens. The anesthesia is injected into a vein and you are asleep withing 15 seconds. The next thing I remembered was someone saying “take a deep breath” when it was time to wake up.

A final pre-op test leaves some “burping” side effects. The heart is hidden behind the stomach, so one of the last tests is to insert a tube down your esophagus into the stomach. Then an ultrasound device is inserted into the stomach to get a final real time picture of the heart. (You are also put asleep for this procedure.)  This test is to make sure there are not any unforeseen problems that would complicate surgery. This procedure can have a lot of side effects that last many months. Some people experience a sore throat (I did not). Most people find that their stomach may be sore for a few weeks. To help the stomach heal you will be given stomach medicine for a few weeks. Many people find that they burp a lot more than they used to, even months after this procedure. Even 9 months after the procedure I still get these burps once and a while. Patients feel embarrassed to mention this to a doctor, since they think it is somehow their own fault. These burps are a perfectly normal side effect and very common.

Bring someone with you to the hospital! Don’t try to do it on your own. You need someone you can count on to stay with you the whole day. Bring a spouse, partner, friend or grown child. In my case, my wife Susan was with me all day. You need your special someone to help you navigate through the system and to listed to what the doctors and nurses say. You will be too groggy, distracted or upset to completely understand all the instructions being given to you.

You are in for a Long, Long day. Before the actual surgery, there is paperwork, pre-op tests,  and preparation. You will be wheeled from place to place, have tubes and needles stuck into you and spend most of your time in a cold hospital gown. All this happens before the actual Catheter Ablation Surgery. In my case, I got to the hospital at 7am and my surgery began at 4PM. I was done about 7PM.

You are only in the hospital for 1 night. In my case, the hospital was so full that there were no rooms, so I spent the night in the recovery ward. I was not actually sleepy. After all, I had been sleeping for many hours as part of the surgery. It is interesting the things you hear in a hospital recovery ward overnight.  The nurses try to speak quietly, but I was so bored I eavesdropped on every conversation. They spent a lot of time gossiping about another nurse, who they claimed always walks around trying to look busy, but who does not actually help anyone.

You will need help getting home. Don’t kid yourself, they may call it non-invasive, but someone was just inside your heart. You are going to be exhausted. Too weak to drive yourself home, or even Uber by yourself.

You should rest at home for 1 week before going back to work.  You will be very tired. This is perfectly normal and does not mean that anything is wrong with you.

You may be very sore from just lying on the operating room table. My right shoulder was very sore and weak and I had trouble lifting it for a day or two. This is a normal side effect and you may experience body aches and pains from having been immobile for so long.

Do not lift more than 10 pounds for a month after Catheter Ablation Surgery

Do not lift more than 10 pounds for a month after Catheter Ablation Surgery

Do not lift anything heavier then 10 pounds for a month. This is so that you do not rip open the wounds where the surgeon made incisions in your groin. This instruction is very hard to follow. It is amazing how many things weigh more than 10 pounds.  Don’t rip open your wounds by doing something stupid like lifting a heavy bag of groceries, a Thanksgiving turkey or a full garbage can. It does not matter if you are an Olympic weightlifter and can normally lift hundreds of pounds with ease. You have to give these wounds time to heal.

Do not run for at least 1 month after Catheter Ablation Surgery.

Do not run for at least 1 month after Catheter Ablation Surgery.

Do not Run for a full month. This is also to keep the groin wounds from ripping open. Running and even standing for long periods of time put a lit of strain on this area.

Ask your doctor about the type of adhesive used in the bandages. Some people are allergic to the type of adhesive used in the bandages that cover the groin incisions. I happened to be one of them. This allergic reaction can leave you with very painful blisters. Find out ahead of time if there are any alternative adhesives available.

You will have AFib for a few months after your surgery. Sometimes this will be even worse than the AFib you experienced before. This is also perfectly normal but is very hard to accept. The AFib episodes do not go away until the parts of the heart burned by the surgeon have scarred over. Even though you know ahead of time that this is going to happen it is psychologically very stressful.  You will be asking yourself “what was the point of all that pain and effort if the AFib is still there?” With successful surgery, these episodes will gradually disappear, and in many cases go away forever. Part of the process is that your heart has to re-train itself not to go into AFib.

Catheter Ablation Surgery does not fix any other cardio problems. For example, if you had high blood pressure or high cholesterol before the surgery, the surgery does nothing to change that. Just because your heart now no longer goes into AFib does not mean you can go wild and load up on cream fill doughnuts every morning. You still have to take care of yourself, eat heart-healthy and exercise.

A happy heart

A happy heart

So, that’s my patient’s-view story of Catheter Ablation Surgery. I hope it gives you some useful information.  Remember always that if you have heart problems there are lots of people who care and who can help you. Be well and be happy.

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