After having cardiac ablation

An ablation procedure is a treatment for a heart condition called atrial fibrillation. This is an irregular heart rhythm, which starts in the upper chambers (atria) of the heart.

We can do an ablation procedure to treat areas of the heart involved in heart rhythm problems. If you have atrial fibrillation, we will target the atria with ablation treatment.

After the procedure

After your ablation procedure:

• you wake up from the general anaesthetic 
• we take you to the recovery area, where a nurse monitors your pulse and blood pressure
• you have a cardiac (heart) monitor, which the nurse uses to check your heart rhythm

The nurse regularly checks your groin for any bleeding and swelling. They may put a pressure dressing at the top of your leg to reduce the risk of bleeding. For the same reason, you need to stay in bed for 3 to 6 hours before you can sit up, stand and then walk.

You are likely to have a plaster or dressing on your groin wounds when you wake up from the procedure. 

The plaster or dressing on your groin wounds can be removed on the day after your procedure. It does not need to be replaced. You only need to replace the dressing if a wound starts to bleed.

When you have an ablation procedure, you do not usually need to stay in hospital overnight. You can leave hospital when your nurse is confident that you are fit enough. This means that you need to be able to:

• move around comfortably (mobilise)
• pee without problems
• eat and drink

Before you leave hospital, we explain any changes that you need to make to your medicines.

After you leave hospital

Most people recover quickly from an ablation procedure and feel well enough to continue their usual activities the next day. Here are some practical tips to help you while you recover:

Side effects of the procedure

You may have side effects after your ablation procedure.

Bruising at the puncture sites

It is common to have bruising at the puncture sites. This sometimes spreads down the leg towards the knee. Your anticoagulant medicines may make the bruising worse.

You may also get a small (pea size), hard lump in the groin. This should settle gradually. However, if there is redness, increasing swelling or noticeable pain over the lump, a health professional needs to review it. The redness may be harder to notice on brown and black skin.

Discomfort in the chest, neck and shoulder

You may have some discomfort in the chest, neck and shoulder. This may:

• feel sharp or stabbing
• be worse when you lie down or take a deep breath
• improve when you sit forward

Pain medicines that you buy in a pharmacy or shop can help you to manage these symptoms. The discomfort usually settles in the first week after the procedure.

The blanking period

You may have episodes of atrial fibrillation or irregularities in your heart rhythm during the first 3 months after your ablation. This is often called the blanking period.

The symptoms are usually caused by inflammation after the procedure. They are likely to settle with time. Getting these symptoms within the first 3 months does not mean that the procedure has been unsuccessful.

Episodes of atrial fibrillation can last for minutes, hours or days.

There are several wearable devices that can produce an ECG. The most commonly used are probably the:

• AliveCor KardiaMobile™ device
• Apple Watch

We are happy to receive ECG readings by email.

If you do not have access to an ECG service at a GP surgery, a wearable device or email, please call the arrhythmia clinical nurse specialists. They can organise an ECG for you.

Atrial fibrillation is not a life-threatening condition, but it can make you feel unwell. If you have any new medical concerns when you leave hospital, it is important to contact a GP. 

In an emergency, call 999 or go to your nearest emergency department (A&E). 

When to get medical help

Follow-up appointments

You are likely to have a follow-up clinic appointment about 3 months after your ablation. Before this appointment, we may give you a heart rhythm monitor and ask you to wear it for 24 hours or longer.

Your follow-up appointment may be held:

• by video
• by phone
• in person with a health professional

There can sometimes be a delay in arranging your appointment. Please tell your health professional if you have access to an approved personal ECG device, such as the AliveCor KardiaMobile™.

You do not have to contact us to arrange your follow-up appointment. We have a patient app called MyChart, which you can use on your mobile, tablet or computer.

If you have signed up to use MyChart, you will get a notification of your appointment within the MyChart portal. This includes the date, time and place of the appointment.

If you have not signed up to use MyChart, you will get either:

• a text message notification of your follow-up appointment, or
• an appointment letter

This depends on the communication preferences that we have recorded for you.

At your follow-up appointment, we:

• review your symptoms
• explain whether your medicines can be reduced or stopped

Keeping to a healthy lifestyle

Various aspects of a person's lifestyle can increase the risk of atrial fibrillation. They include:

• being overweight (obesity)
• having a low fitness level
• following an unhealthy diet
• smoking
• drinking alcohol

If you try to have a healthy lifestyle before and after your ablation, this will reduce the risk of repeated atrial fibrillation episodes. A healthy lifestyle means:

• keeping to a healthy weight for your height (this is called your body mass index)
• doing regular exercise
• following a healthy, balanced diet
• stopping smoking
• avoiding alcohol or only drinking a limited (moderate) amount

There are many NHS resources available to help you keep to a healthy lifestyle. Please speak to your health professional if you would like more information or support.

MyChart

Our preferred method for contacting you is through the MyChart electronic patient portal. Within this portal, we can send you requests to:

• complete questionnaires about your symptoms
• get a heart rhythm reading by having an ECG or using one of the accepted mobile devices that can produce an ECG

Support and more information

You can find more information about atrial fibrillation and ablation on the following websites:

• NHS Choices: www.nhs.uk/conditions/atrial-fibrillation
• Afib Matters: www.afibmatters.org
• British Heart Foundation: www.bhf.org.uk/informationsupport/treatments/ablation