Atrial fibrillation ablation is a catheter-based procedure used to treat atrial fibrillation by isolating or modifying abnormal electrical pathways within the heart. Your cardiologist will discuss the procedure itself with you. This page explains what to expect from the anaesthetic perspective.
What type of anaesthetic is used?
Most atrial fibrillation ablation procedures are performed under general anaesthesia. This helps provide immobility, stable breathing conditions and a controlled environment for a precise electrophysiology procedure.
The procedure commonly takes around 1.5 to 2 hours, although the exact duration can vary depending on the type and complexity of the case.
Before the procedure
Before your procedure, I will review your medical history, medications, allergies, previous anaesthetic history and any issues relevant to your heart rhythm condition.
It is particularly important that your treating team is aware of:
- anticoagulants or blood-thinning medicines
- diabetes or weight-loss medicines
- previous problems with anaesthesia
- reflux, swallowing problems or sleep apnoea
You will also be given fasting instructions before the procedure.
What happens during the anaesthetic?
Once in the procedure room, monitoring will be attached and an intravenous cannula will be used for fluids and medications.
During the procedure you will usually have:
- a general anaesthetic
- a breathing tube placed while you are asleep
- mechanical ventilation while anaesthetised
- EEG monitoring to help assess the state of anaesthesia
- careful heart, oxygen and blood pressure monitoring throughout
Why is an arterial line used?
An arterial line is routinely used for atrial fibrillation ablation procedures. This is a small cannula placed into an artery, usually at the wrist.
It allows:
- beat-to-beat blood pressure monitoring throughout the procedure
- blood sampling during the case
- close monitoring of the state of anticoagulation used during the procedure
Is ultrasound of the heart used?
In atrial fibrillation ablation procedures, a transoesophageal echocardiogram (TOE) will usually be performed during the anaesthetic. This involves passing an ultrasound probe into the oesophagus while you are anaesthetised to obtain detailed images of the heart and help guide the procedure.
What should I expect afterwards?
At the end of the procedure, the anaesthetic is stopped and you will wake in the recovery area. The breathing tube is removed as you wake up, and you will be monitored closely before returning to the ward.
Most patients have minimal or no pain after atrial fibrillation ablation. The most common temporary symptoms are:
- mild groin discomfort
- tiredness
- a sore throat for a day or two, particularly if a TOE has been used
- occasionally mild dizziness
Nausea and vomiting are uncommon after this procedure.
Important medication note
Please follow the instructions provided by your cardiologist, hospital and anaesthetist regarding anticoagulants and other medicines before the procedure. Do not stop or continue blood-thinning medication without explicit advice.
General information only
This page provides general information only. The anaesthetic plan for your procedure will be tailored to your medical history, the electrophysiology plan and the preferences of your treating team.