If you have your procedure as an outpatient, you will arrive at the Day Unit either from home or by ambulance from a referring hospital. Although your procedure will take anywhere from one to four hours, expect to be at the Heart Institute for a total of eight to 12 hours.
The Day Unit is located on the first floor. Take the elevators from the main lobby at the Heart Institute up to the first floor. Once there, follow the green hearts on the floor to the Day Unit. You will be in the Day Unit until you are ready to go to the EP Lab. Before you go for the procedure, the doctor will come and meet with you in the Day Unit; this will be a good time to ask any final questions you may have.
Only one relative or friend will be allowed to sit with you while you are waiting because space is limited. During your procedure, your relative or friend may wait in the lounge area. When your procedure is completed, the staff will notify your designated contact person.
Visiting hours in the Day Unit are from 9:00 a.m. to 9:00 p.m.
Once you are in the Day Unit, the final preparations for your procedure will start. You will change into a hospital gown. Your groin area will be clipped of hair and cleaned. You may have an intravenous tube placed in your arm.
Make sure the nurse knows the name, phone number and location of your designated contact person.
During Your Procedure
Your study will take place in the EP Lab at the Heart Institute. You will be given medication to help you relax, and you may fall asleep. If you continue to feel anxious even after receiving the medication, let the nurse know.
There will be a team of doctors, nurses and lab technologists involved in your procedure. All staff will be wearing gowns and special lead aprons.
The doctor will use a local anesthetic to numb the area around your groin. Once the area is numb, small, thin tubes will be inserted there.
Anywhere from three to five soft catheters will be inserted through the tubes and threaded up into your heart. A small amount of X-ray imaging will be used to help with proper placement of the catheters.
During the insertion process, you may feel some pressure in your groin and some palpitations. Let the staff know if this becomes too uncomfortable.
When the catheters are properly positioned, various recordings and measurements of the electrical activity in your heart will start. This may involve pacing your heartbeat at different speeds, stimulating various types of arrhythmias, or even giving you different medications through your intravenous tube and measuring whether your heart rhythm responds.
All this activity will provide the team with important information about the exact nature and location of your heart arrhythmia and what the best strategy is to treat it. An EP study usually lasts anywhere from 15 to 45 minutes.
Catheter ablation may take an extra one to four hours. During the ablation, an extra-soft catheter is inserted. The tip of the catheter is directed toward the areas in your heart that are firing off the irregular impulses. Once properly positioned, a small radio-frequency (RF) electrical current is delivered to burn out the tiny malfunctioning areas. While this is happening, you may feel a burning sensation in your chest. Let the nurse know if this becomes very uncomfortable. Depending on the type of arrhythmia, the radio-frequency current may need to be applied several times. Atrial flutter usually needs the most RF applications.
Once the ablation is completed, there is further observation and testing to ensure that the arrhythmia has been eliminated. Sometimes the ablation needs to be repeated. When the team is satisfied with the results, the catheters are removed. Once you are ready, you will be brought back to the Day Unit to complete your recovery.