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At the end of your catheter ablation, the EP will remove the catheters and apply pressure or a collagen patch to avoid bleeding at the catheter insertion site. To prevent bleeding, you may lay on your back and stay still for a few hours, though you may be out much of that time from anesthesia. During that time, you’ll be hooked up to a telemetry monitor that uses EKG-like patches and displays your heart rhythm.
Most patients are discharged from the hospital in less than 24 hours, making catheter ablation an outpatient procedure. However, during the COVID-19 pandemic, many centers moved to same-day discharge, making it a day procedure.
Expect to be tired and out of it, with some chest soreness and discomfort, for a day or two. It is common to experience afib, heart palpitations, and/or an increased heart rate after any heart procedure. That generally subsides once your heart heals, usually within three months. You may be placed on an antiarrhythmic drug for a few months to manage any afib episodes.
Your doctor may tell you to avoid baths and swimming and avoid lifting for up to a week following the procedure. You may also wish to give yourself plenty of time to recover before resuming work or vigorous physical activity that may stress the body. In addition, you might need to alter the usual intensity of your physical activities and exercises. Therefore, it may be advisable to take it slow and make modifications until you build back up your strength.
Stroke Prevention After Ablation
You may be on an anticoagulant for two to three months after the procedure to prevent blood clots. The anticoagulant will be Coumadin (warfarin) or one of the newer direct oral anticoagulants (DOACs), which include Pradaxa (dabigatran), Xarelto (rivaroxaban), Eliquis (apixaban), and Savaysa (edoxaban).
The CHA2DS2-VASc scoring system is used to determine your risk of a stroke. If you were on an anticoagulant before your ablation, you would likely stay on one afterward. Even after a successful ablation, you might still have episodes of asymptomatic (or silent) afib, events that can increase your risk for a stroke. The DISCERN AF clinical trial showed that asymptomatic to symptomatic afib episodes increased from 1.1 before ablation to 3.7 after.1
A recent point of interest related to strokes and afib is whether the afib causes the strokes or whether the diseased atrium does, in which case afib may be the symptom rather than the cause. To learn more about this thinking, see Is It Afib That Causes Strokes, or Maybe Something Else?
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Follow-Up Visits After Ablation
The HRS Consensus Statement suggests that all patients who undergo catheter ablation of afib should be seen for follow-up for at least 3 months after ablation. Afterward, patients are recommended to be seen annually by a physician (family physician, internist, cardiologist, or electrophysiologist).2
Follow-up visits after the procedure will generally involve many of the same tests as before the procedure, such as:
- Electrocardiogram (ECG)
- Echocardiogram
- Transesophageal echocardiogram (TEE)
- Computed tomography (CT)
- Holter monitor test
- International Normalized Ratio (INR) if on Coumadin or warfarin
- Other blood tests or lab work
Monitoring Afib Following Ablation
There are many cardiac monitoring devices that can be used to detect afib and assess whether a catheter ablation was a success. Traditional medical-grade monitoring methods include electrocardiogram (ECG), Holter monitor, and mobile cardiac telemetry. Frequently, an insertable cardiac monitor (ICM), often called an implantable loop recorder (ILR), may be inserted following an ablation to track the heart rhythm for up to several years. There are also consumer devices that may prove useful for monitoring after an ablation. Learn more about these monitoring devices at Monitoring Devices For Afib.
Regardless of the monitoring device used, it is essential to remember that afib may still occur after the ablation. Many people experience some atrial fibrillation or atrial flutter after a catheter ablation due to inflammation of the heart tissue. For this reason, the first three months are generally considered a “blanking period” during which time success or failure should not be judged.
Some people are concerned that afib during the three-month blanking period means the catheter ablation has failed; however, we often hear at medical conferences that more inflammation may be correlated with more aggressive treatment, often resulting in less afib once the inflammation has subsided and the heart has healed.
The HRS Consensus Statement2 discusses these afib recurrences following ablation:
Since early recurrences of afib and/or the development of atrial tachycardia are common during the first 2–3 months after afib ablation and might resolve spontaneously, repeat ablation procedures should be deferred for at least 3 months following the initial procedure if possible.Atrial fibrillation recurrences during the first 3 months after ablation are rather common. It is generally believed that the mechanisms of afib in this setting are different from that of the patient’s clinical arrhythmia. Acute inflammatory changes owing to energy delivery; modification of the autonomic nervous system with consecutive changes in the atrial substrate; or delayed effect of radiofrequency ablation due to lesion consolidation have been considered. It is also suggested that afib might resolve completely upon resolution of the transient factors promoting early afib recurrences. Accordingly, suppressive antiarrhythmic agents are frequently prescribed for patients with atrial fibrillation recurrences during the first 1–3 months following ablation.
Just knowing that this may happen can help ease the disappointment and frustration if it does. If you can focus on recovery, you’ll soon be healed. Many patients find that previously failed medications now work to hold back the afib and get them past these initial few months.
For more information about catheter ablation, see Catheter Ablation. To learn about other atrial fibrillation procedures, see Procedures for Afib.
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FAQs
How long does it take to recover from atrial fibrillation ablation? ›
“If they're feeling well and if their work isn't too strenuous, I tell most patients that it's okay to go back to work 3 to 4 days after their ablation,” Dr. Arkles says. For strenuous jobs like nursing or law enforcement, he recommends a two-week wait.
Do and don'ts after heart ablation? ›After catheter ablation, you should avoid heavy lifting and strenuous exercise for at least three days. Talk with your provider about when it's safe to return to physical activity. After surgical ablation, you'll spend about a week in the hospital.
How soon after cardiac ablation Do you feel better? ›Some people feel a little sore after the procedure. The soreness shouldn't last more than a week. Most people can return to their daily activities within a few days after having cardiac ablation.
What to expect after ablation for atrial fibrillation? ›You may feel a little sore after your procedure, but the soreness shouldn't last more than a week. You'll usually be able to return to your daily activities within a few days after atrial fibrillation ablation.
Is it common to go in and out of AFib after ablation? ›Recurrent AF after catheter ablation occurs in at least 20 to 40% of patients. Repeat ablation is primarily considered for those with symptomatic AF recurrences (often drug-refactory) occurring at least 3 months or more post-ablation.
Is AFib ablation major surgery? ›What is catheter ablation, exactly? Catheter ablation is a minimally-invasive technique intended to cure atrial fibrillation without major surgery.
What is the downside of an ablation? ›Pregnancy after ablation, while rare, carries risk of miscarriage and complications. Bleeding may still occur after ablation, a hysterectomy may be needed in the future. The procedure carries risks (e.g., infection, bleeding, damage to uterine wall or bowel).
How do you sleep after a heart ablation? ›If you have pain, take your pain medication about ½ hour before bedtime. Arrange the pillows so you can maintain a comfortable position and decrease muscle strain. Avoid napping too much during the day. Remember to balance activity with rest during recovery from open heart surgery.
How long does fatigue last after cardiac ablation? ›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.
Why do I feel so tired after cardiac ablation? ›Also, your heart rhythm may feel faster than usual for a period of time and you may feel tired as your heart and body need time to adjust. These symptoms will improve on their own over time. It is likely during this period that your doctor will recommend that you continue to take your arrhythmia medication.
Can AFib worse after ablation? ›
However, AF ablation frequently results in temporary increased atrial arrhythmias and worsened symptoms in the first three to six months after the procedure with reported incidence ranging from 1.2–40%.
How long after ablation do you know if it worked? ›Does ablation work straight away? You may still have symptoms, such as palpitations, in the weeks following the procedure. For some ablation techniques, you will need to wait three months to see if the treatment was successful.
Does ablation permanently fix AFib? ›Does Ablation Cure AFib? AFib may go away for a long time, but it can return. It's rare, but if you have persistent or chronic AFib, you might need a second ablation within 1 year. If you've had AFib for more than a year, you may need one or more treatments to fix the problem.
What are the pros and cons of ablation for AFib? ›During ablation, the abnormal heart tissue is destroyed by burning or freezing it. Ablation has a greater chance of reducing and even eliminating your symptoms and making you feel better. But the procedure is invasive, expensive, and not right for everybody.
How successful is ablation for AFib 2022? ›High Rates of Success for Both Early-Stage and Advanced AFib
For patients in the early stages of AFib, with symptoms that come and go (known as paroxysmal AFib), catheter ablation has an 80 to 90 percent success rate.
The most serious complications of ablation for AF are cardiac tamponade, stroke, pulmonary vein stenosis, phrenic nerve paralysis, and atrioesophageal fistula. [17] However, the risk of death is acceptable with an overall mortality rate of approximately 1 per 1000.
What causes AFib to start? ›Causes of atrial fibrillation
Coronary artery disease. Heart attack. Heart defect that you're born with (congenital heart defect) Heart valve problems.
Beta blockers and calcium channel blockers are the drugs of choice because they provide rapid rate control. These drugs are effective in reducing the heart rate at rest and during exercise in patients with atrial fibrillation.
Is AFib considered heart disease? ›Atrial fibrillation is a progressive disease, so it is not uncommon for people with paroxysmal AF to develop persistent or permanent AF over time.
What are the chances of AFib returning after ablation? ›Atrial fibrillation ablation, mainly via pulmonary vein isolation, is an effective and safe intervention to restore and maintain sinus rhythm. Recurrence of AF after catheter ablation is estimated to be between 20% and 45%.
What are the after effects of a heart ablation? ›
Risks Associated with Ablation
Bruising or bleeding after the procedure where catheter was placed. Blood clots. Heart attack or stroke. Narrowing of veins to heart may occur.
After a successful catheter ablation, those with lone a-fib are less likely to have a recurrence. But some lone A-Fib patients do have recurrences. (Some studies estimate a 7% chance of recurrence out to five years, though most recurrences occur in the first six to 12 months.)
How long after a heart ablation can you go home? ›This area should heal and close in 1 to 2 days. Most patients will be able to go home the same day as the procedure. In case you need to stay overnight in the hospital, please pack an overnight bag with your personal items. Don't bring any valuables to the hospital.
How long before you know if ablation worked? ›Does ablation work straight away? You may still have symptoms, such as palpitations, in the weeks following the procedure. For some ablation techniques, you will need to wait three months to see if the treatment was successful.
Does AFib get worse after ablation? ›However, AF ablation frequently results in temporary increased atrial arrhythmias and worsened symptoms in the first three to six months after the procedure with reported incidence ranging from 1.2–40%.
What is the next step if ablation doesn't work? ›If the ablation doesn't work first time and your symptoms either don't improve or return, you may need another ablation or to think about other treatments. You should get in touch with your doctor or clinic to talk about your other options.
Do you need bed rest after ablation? ›Background: After radiofrequency catheter ablation of arrhythmias, patients have to bed rest for 4-6 h to prevent bleeding and hematoma. However, such a rest may cause back pain in the patients.
When can I drive after cardiac ablation? ›The procedure always requires an overnight stay. You will not be able to drive for 24 hours. You should also not lift, push or pull anything more than 10 pounds for 3 days following the procedure.