A PULSED FIELD ABLATION FOR A CHANGE (ABLATION #4)

 

Adventures of a Racing Heart – A Pulsed Field Ablation this time!

So, to the words of the old Whitesnake song “Here I go again now…”.  Back to Papworth for ablation number 4.  I’d previously had the cryoablation isolating the pulmonary veins in 2020, eleven months later in 2021 a Radio-Frequency ablation of Left atrium and then eight months after that another RF of Left Atrium.  Needless to say, I was not frightfully happy about having this done again and not very confident about the outcome, but I’d been warned I could not stay on amiodarone for years and years so felt I had no choice.

This time I was not due to the hospital until 11 am which left a hideous amount of time to hang around the house being nervous especially as I had to be up to eat a light breakfast at 7 am.

On and off since the Friday afternoon, three days earlier, I was in some sort of tachycardia – started after doing some crouching while weeding in the garden.  This continued off and, on all weekend, but seemed all right on this Monday morning.  Obviously, after over five weeks off the amiodarone its magic was ceasing to work.

Once dropped off Papworth it was the usual routine.  Hang around in reception.  Hang around by the bed.  Change into a dashing outfit of paper pyjamas, support tights and non-slip socks.  Hang around.  Shave the pubic region (done it already – I’m experienced in this ablation lark). Hang around.  Height/weight/blood pressure.  Hang around. Answer lots of questions.  Hang around. Charm the staff by taking along homemade Tiffin!  Hang around.

Move to lounge.  Hang around there for a change.  Watch everyone having lunch.  Hang around. It’s freezing in here especially wearing only paper clothes.  Get a blanket.  Hang around. Finally see the cardiologist.  Answer more questions – have the procedure explained.  Sign your life away.  Back to the lounge. Hang around.

Go to the loo a few more dozen times.  Try to read a book.  Chat to my Electrocardiologist who explains it again.  Says he’ll see me after lunch.  Try not to think about food as I’m starving and thirsty.  Go to the loo.  Go to the loo again.  And again. 

Finally, getting on for 2 pm get collected by two assistants from the Cath Lab.  Decide I need the loo again.  Walk down to the Cath lab in my sexy paper pyjamas trying not to lose them as I go!

Once in the Cath Lab it all begins.  After hours of hanging around suddenly it’s all rush and tear.  There are what seems like dozens of hands and people are all over you – sticking lots of ice-cold pads on my back (for the ablation).  This time there were more of these – presumably for the Radio-frequency machine and the pulsed-field machine.  Pads on top of those pads (for the cardioversion).  Each pad icier than the one before.  Joke with staff that they keep them in the freezer on purpose.

Meanwhile answer all the questions from the anaesthetist (here’s a funny thing – this was my 8^th GA as an adult and I’d never had a woman anaesthetist until the nose op five weeks ago – when there were two.  This time is another woman.  Great stuff).  She is also sticking a canula in my hand at the same time while I am jumping because of the coldness of the pads!  Everyone is asking questions about my height, my weight, who I am, what am I having done, do I understand what is going on?  All the staff are super-friendly and everyone introduces themselves by name.  They seem from all over the world – I guess at a German/Nordic speaker, a Spanish or Portuguese amongst others.  A thing (I can’t see it, but it feels narrow and long) is stuck across my forehead – this is new!  I ask the anaesthetist – seems it is to monitor brainwaves so they can make sure you are sedated but also so they can give you the smallest amount of anaesthetic possible to do the trick.  It originated in the US where people kept suing and saying they’d been awake during their op!  But Papworth have just introduced it for all their ops.

The anaesthetist is concerned about my HHT nosebleeds and shocked when I say I have them 3-8 times per week for up to an hour.  She thinks this is horrendous – I tell her it is only classified as medium.  At least she knows what HHT is!  One of the staff asks her if it a short procedure to which the anaesthetist replies no, but that she doesn’t want me “under too deep in case I start to bleed” (first time anyone has ever said that!).  They start telling me to imagine I am on a beach – I say I’d sooner be walking in the Alps, we start talking about that.

They set up the saline drip and the drugs.  They are still asking me about my holiday – how high did I climb, what’s the highest I have ever been, but I have an oxygen mask on so can’t say much. It’s like having the dentist talk to you! 

They tell me I will feel drowsy.  I don’t. As usual I panic that I will be awake throughout.  I keep my eyes open so they know I am awake.  Then that painful coldness in the hand and arm and bye bye…

I wake up some 3.5 hours later in recovery.  I can’t stop coughing.  Over and over.  The nurses (there are two) tell me to put pressure on the wound when I cough.  It’s easier said than done when you are still fairly out of things. They offer me a drink to help the coughing but I cannot sit up so it’s tricky.

My EP comes to see me – tells me some stuff about the procedure but I am a bit out of it still, but he seems happy. 

I float around in a haze of drugs and coughing for what seems an age.  The EP’s assistant comes to see me and tells me the same stuff the EP did but this time I take in more of it:

They checked all the previous work, found one gap and did that.  Decided to do right atrium too this time.  All went well and they are confident.  They say that every time so I don’t take too much notice!

Eventually I am taken back to the ward for more coughing and lying flat.  Eventually “the drain” is taken out (!) and I have to lie another 30 mins.  Then I can sit up.  I don’t ‘die’ this time (see ablation #2). 

They keep trying to feed me.   I don’t fancy anything yet.  Seems to take me longer each time to wake up after a GA.  Eventually I decide I fancy the Lasagne and ask the catering lady for that.  She says I’m not allowed to have that but she does have a bit of fish (this has been knocking around for a bit as I heard her complaining that someone had ordered it and not wanted it or something).  Being an eat-anything person, I accept that.  I find out later that only overnight patients can have hot food – day cases can only have sandwiches!!!!!!!

I’m ready to go by 7.15 pm and by the time my husband gets there and I painfully get dressed and limp downstairs it is gone 8 pm and the whole unit is shut with all the staff waiting for me to go! 

I’m very apologetic, but I did make them cake so they forgive me!! 😊

 

So overall what did I notice this time – apart from all the hanging around which you don’t get if you go in on the early ‘shift’?  Loads of staff in the Cath Lab – I reckon at least eight excluding the EP and his assistant who I can’t see, but that is usual.  Staff are super friendly and attentive.  They do their utmost to relax you.  Other than that - lots of pads, my whole back was smothered with them.  As mentioned, they had to put the cardioversion pads on top of the others.  And, boy, how do they keep those pads so cold, but that’s usual.  So, no real difference to the others.  Sorry - that's boring!!