travel after heart ablation

The Benefits And Precautions For Traveling After Cardiac Ablation: What You Need To Know

• Last updated Jul 18, 2023
• Difficulty Beginner

• Category Ablation

Traveling after a cardiac ablation can be an incredible opportunity to explore new places, experience different cultures, and create lasting memories. After undergoing this procedure, you may feel a renewed sense of energy and vitality, making it the perfect time to embark on an adventure. Whether you're planning a relaxing beach vacation or an exciting city getaway, taking time to travel can help you relax, rejuvenate, and celebrate your improved heart health. So pack your bags, embrace the journey, and let your heart lead the way!

What You'll Learn

How soon can i travel after undergoing a cardiac ablation procedure, are there any specific precautions i should take while traveling after cardiac ablation, is it safe to travel long distances or by plane after cardiac ablation, what should i do in case of an emergency while traveling after cardiac ablation, are there any destinations or activities that i should avoid during the recovery period after cardiac ablation.

Cardiac ablation is a procedure used to treat certain heart rhythm disorders, such as atrial fibrillation or supraventricular tachycardia. It involves using heat or cold energy to destroy the abnormal tissue causing the irregular heart rhythm. After undergoing cardiac ablation, it is natural to have concerns about when it is safe to travel again. The exact timing can vary depending on individual factors, so it is important to consult with your healthcare provider for personalized advice. However, here are some general guidelines to help you understand when you might be able to resume traveling after a cardiac ablation procedure.

Recovery time after cardiac ablation can vary from person to person. In some cases, individuals may be able to resume normal activities, including travel, within a few days or weeks. Others may require a longer recovery period. The duration of recovery depends on various factors, such as the extent of the procedure, the overall health of the patient, and any potential complications that may have occurred during the procedure.

Immediately after the procedure, you may need to stay overnight in the hospital for observation. During this time, your healthcare team will monitor your vital signs and ensure that you are stable before allowing you to go home. In some cases, you may need to take medications to prevent blood clots or manage your heart rhythm, so it is essential to follow your doctor's instructions regarding medications and any restrictions on physical activity.

Once you are discharged from the hospital, it is important to give your body time to heal. Your healthcare provider will provide specific instructions on post-procedure care, including any limitations or restrictions on physical activity. It is crucial to follow these guidelines to give yourself the best chance at a successful recovery. In general, it is advisable to avoid vigorous exercise or heavy lifting for a period after the procedure to allow your heart to heal properly.

The decision to travel after cardiac ablation should be based on your individual circumstances and the advice of your healthcare provider. It is important to consider factors such as the duration of the travel, mode of transportation, availability of medical facilities at your destination, and any potential risks associated with flying or long periods of sitting.

If you are planning to travel shortly after your cardiac ablation procedure, it is a good idea to check with your doctor to ensure that you are medically fit to travel. They may recommend delaying your travel until you have had an opportunity to recover fully. In some cases, they may be able to provide specific recommendations or precautions to take during your journey.

While traveling after a cardiac ablation procedure is generally safe for most patients, there are some precautions you should consider. It is advisable to carry a copy of your medical records and a letter from your doctor detailing the procedure you have undergone and any necessary medications or precautions. This information can be helpful in case of any medical emergencies or if you need to seek medical care while away from home.

Additionally, it is important to listen to your body during and after your trip. Take frequent breaks to rest and stretch, especially if you are traveling for an extended period or have a long flight. Stay hydrated and avoid excessive caffeine or alcohol, as these can affect your heart rhythm. If you experience any concerning symptoms, such as chest pain, shortness of breath, dizziness, or palpitations, seek medical attention immediately.

In conclusion, the timing of travel after undergoing a cardiac ablation procedure can vary from person to person. It is important to consult with your healthcare provider for personalized advice based on your individual circumstances. Generally, it is advisable to give yourself time to recover and follow any post-procedure instructions provided by your doctor. With proper care and guidance, many individuals are able to resume travel within a few weeks after cardiac ablation.

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Cardiac ablation is a procedure used to treat certain heart rhythm disorders, such as atrial fibrillation. After undergoing cardiac ablation, it is important to take some precautions while traveling to ensure your safety and well-being. Here are some specific precautions to consider:

• Consult with your healthcare provider: Before planning any travel, it is essential to discuss your travel plans with your healthcare provider. They can assess your condition and provide guidance on whether it is safe for you to travel, as well as any specific precautions you need to take.
• Take prescribed medications: Make sure you continue taking any prescribed medications as instructed, even while traveling. This is important for maintaining the success of the ablation procedure and preventing any further heart rhythm issues. Carry your medications in your carry-on luggage, along with a written list of medications and dosages, in case you need to seek medical assistance while away.
• Avoid strenuous activities: While traveling, it is advisable to avoid engaging in strenuous activities such as heavy lifting or intense physical exercise. These activities can increase your heart rate and put unnecessary strain on your heart. Instead, opt for light activities like walking or swimming, and take breaks as needed.
• Stay hydrated: Dehydration can exacerbate heart rhythm disorders and increase the risk of complications. It is important to stay hydrated while traveling, especially in warmer climates or during long flights. Drink plenty of water and avoid excessive alcohol or caffeine consumption, as they can contribute to dehydration.
• Take frequent breaks: Long periods of sitting, such as during flights or long car rides, can increase the risk of blood clots. To reduce this risk, take frequent breaks to stretch your legs and walk around. If you are on a long flight, consider wearing compression stockings, which can help promote blood circulation.
• Be prepared for emergencies: It is essential to be prepared for any unforeseen medical emergencies while traveling. Carry a copy of your medical records, including a summary of your cardiac ablation procedure, any relevant test results, and contact information for your healthcare provider. Research the availability of medical facilities at your travel destination and have a plan in place in case you need immediate medical attention.
• Listen to your body: Pay close attention to how you feel while traveling and listen to your body. If you experience any symptoms such as chest pain, shortness of breath, dizziness, or palpitations, seek medical assistance immediately. It is better to be cautious and seek medical advice when in doubt.

Traveling after cardiac ablation can be safe and enjoyable when the appropriate precautions are taken. By consulting with your healthcare provider, taking prescribed medications, avoiding strenuous activities, staying hydrated, taking frequent breaks, being prepared for emergencies, and listening to your body, you can ensure a smooth and worry-free travel experience. Remember, everyone's recovery process is unique, so it is important to follow your healthcare provider's advice tailored to your specific condition.

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Cardiac ablation is a minimally invasive procedure used to treat certain heart rhythm disorders, such as atrial fibrillation or supraventricular tachycardia. During the procedure, a doctor will use a catheter to destroy or ablate the tissue in the heart that is causing the abnormal heart rhythm.

After undergoing cardiac ablation, it is common for patients to wonder about the safety of traveling long distances or by plane. This is a legitimate concern, as changes in altitude, cabin pressure, and prolonged periods of sitting can potentially have an impact on the heart.

The good news is that most people who have undergone cardiac ablation can safely travel long distances or by plane without any issues. However, it is important to take certain precautions and consult with your healthcare provider before embarking on a trip.

One of the main concerns with traveling after cardiac ablation is the potential for blood clots. The risk of developing blood clots increases during long periods of sitting, such as during a plane ride. To mitigate this risk, you can take steps such as wearing compression stockings, staying adequately hydrated, and moving around or performing leg exercises during the flight. It is also important to avoid crossing your legs, as this can impede blood flow.

Another consideration is changes in altitude and cabin pressure. Some people may experience discomfort or an increase in heart rate during changes in cabin pressure, but this is generally temporary and not a cause for concern. However, if you have recently undergone cardiac ablation, it is advisable to discuss your travel plans with your healthcare provider, who can provide specific guidance based on your individual case.

In general, it is recommended to wait a few days to a week after cardiac ablation before traveling long distances or by plane. This allows time for your body to recover from the procedure and reduces the risk of complications. Your healthcare provider will be able to provide more specific recommendations based on your unique situation.

Real-life experiences of individuals who have traveled after cardiac ablation can also provide valuable insights. Many people have reported being able to travel without any issues, while others have noted increased fatigue during the trip. It is essential to listen to your body and take breaks as needed. If you experience any concerning symptoms during or after the trip, such as chest pain, shortness of breath, or an irregular heart rhythm, it is important to seek medical attention immediately.

To summarize, most individuals who have undergone cardiac ablation can safely travel long distances or by plane. However, it is essential to take precautions such as wearing compression stockings, staying hydrated, and staying active during the flight. It is also crucial to consult with your healthcare provider before traveling to ensure that it is safe based on your specific case. By taking these steps, you can have a safe and enjoyable journey after cardiac ablation.

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If you have recently undergone cardiac ablation and are planning to travel, it is important to be prepared in case of an emergency. While the procedure itself is generally safe and effective, there is always a small risk of complications. Here are some steps you can take to ensure your safety while traveling after cardiac ablation:

• Consult with your doctor: Before embarking on any travel plans, it is crucial to consult with your cardiologist. They will be able to assess your overall health and determine whether it is safe for you to travel. They may also provide you with specific instructions or precautions based on your individual case.
• Carry important documents: Make sure to carry important documents with you, such as a copy of your medical records, a letter from your doctor detailing your condition and any necessary medications, and your health insurance information. This will be helpful in case you need medical assistance while traveling.
• Pack your medications: Remember to bring an ample supply of your medication with you, as well as any necessary medical devices such as a blood pressure monitor or a pulse oximeter. It is also a good idea to pack some over-the-counter pain relievers and anti-nausea medications in case you experience any discomfort or side effects during your trip.
• Research local medical facilities: Before you travel, take the time to research local medical facilities at your destination. Find out if there are any hospitals or clinics nearby that specialize in cardiac care. This information can be invaluable in the event of an emergency.
• Share your itinerary: Make sure someone close to you, such as a family member or a trusted friend, knows your travel itinerary. Provide them with copies of your important documents and let them know how to reach you in case of an emergency. This will ensure that help can be arranged quickly if needed.
• Take it easy: While you may be excited about your trip, it is important to listen to your body and take it easy. Avoid strenuous activities or excessive physical exertion, especially during the first few weeks after cardiac ablation. Pace yourself and rest when needed to avoid putting unnecessary stress on your heart.
• Stay hydrated and maintain a healthy diet: It is important to stay hydrated while traveling, especially if you are taking medications that may cause dehydration. Drink plenty of water throughout the day and try to avoid excessive caffeine or alcohol intake. Additionally, try to maintain a healthy diet by eating nutritious meals and avoiding excessive salt or sugary foods.
• Watch for warning signs: Be vigilant and watch for any warning signs or symptoms that may indicate a problem with your heart. These may include chest pain or discomfort, shortness of breath, dizziness, palpitations, or extreme fatigue. If you experience any of these symptoms, seek medical attention immediately.

In conclusion, while traveling after cardiac ablation can be a rewarding and enjoyable experience, it is important to be prepared in case of an emergency. By following these steps and taking necessary precautions, you can ensure your safety and minimize the risks associated with your condition. Remember to always consult with your doctor before traveling and to listen to your body during your trip.

Causes and Management of Leg Pain After Cardiac Ablation

Cardiac ablation is a procedure used to treat certain heart rhythm disorders, such as atrial fibrillation or atrial flutter. It involves using catheters to deliver energy to the heart tissue in order to create small scars or destroy abnormal electrical pathways. While it is generally a safe procedure with a low risk of complications, there are certain precautions that should be taken during the recovery period.

One of the main considerations after undergoing cardiac ablation is to avoid strenuous physical activities for a certain period of time. The recovery time can vary depending on the individual and the complexity of the procedure, but it is usually recommended to avoid activities that raise your heart rate significantly for at least a week or two after the procedure. This includes activities such as running, heavy lifting, or high-intensity workouts.

Additionally, it is important to avoid engaging in activities that may put you at risk of injury or stress during the recovery period. This could include participating in contact sports, hiking in remote areas without easy access to medical help, or engaging in activities that involve significant changes in temperature, such as saunas or hot tubs. These activities can increase the risk of complications, such as bleeding or infection, which can hinder the healing process.

Furthermore, it is advisable to avoid long-distance travel during the initial recovery period after cardiac ablation. Sitting for prolonged periods, especially in cramped spaces like an airplane, can increase the risk of blood clots forming in the legs, known as deep vein thrombosis (DVT). These clots can potentially travel to the lungs, causing a serious condition known as pulmonary embolism. It is generally recommended to wait at least a week or two before embarking on long flights or car rides to reduce the risk of DVT.

It is important to note that everyone's recovery experience can be different, and it is best to follow the guidance of your healthcare provider. They will be able to provide specific recommendations based on your individual case. Some individuals may have a quicker recovery and may be able to resume normal activities sooner, while others may require more time for the heart tissue to heal.

In conclusion, while cardiac ablation is generally a safe procedure, there are certain precautions that should be taken during the recovery period. It is important to avoid strenuous physical activities, activities that may put you at risk of injury or stress, and long-distance travel in the initial weeks following the procedure. By following these guidelines, you can help ensure a smooth and successful recovery after cardiac ablation.

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Frequently asked questions.

Yes, most people are able to travel following cardiac ablation. However, it is important to consult with your doctor before making any travel plans. They will be able to assess your individual situation and determine if it is safe for you to travel.

While traveling after cardiac ablation, it is important to take certain precautions. You should avoid strenuous activities and excessive physical exertion, as this can put strain on your heart. It is also important to take any prescribed medications as directed, and to bring enough medication with you for the duration of your trip. Additionally, make sure to stay hydrated and maintain a healthy diet while traveling.

If you are planning to fly after cardiac ablation, it is recommended to wait for at least 48 hours before getting on a plane. This allows your body to recover and reduces the risk of complications. It is also important to stay hydrated and move around periodically during the flight to prevent blood clots. Depending on your individual situation, your doctor may have specific recommendations or restrictions for flying, so it's best to check with them before making any travel arrangements.

Altitude and changes in climate can have an impact on your cardiovascular health, so it is important to be mindful of these factors while traveling after cardiac ablation. High altitudes can put extra strain on your heart, so it is important to take it easy and avoid excessive physical exertion. Changes in climate can also affect your body's response to exertion, so it is important to be aware of any symptoms or signs of discomfort and seek medical attention if necessary.

If you experience any symptoms or complications while traveling after cardiac ablation, it is important to seek medical attention immediately. Do not ignore any symptoms, as they could be a sign of a more serious issue. Make sure to have a plan in place for emergency medical care while traveling, and carry any necessary medical information and contact numbers with you at all times. It is always better to err on the side of caution and seek medical help if you have any concerns.

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• Heart & Vascular Services
• Cardiovascular Treatments

What to Expect Before, During, & After Cardiac Ablation

Before your procedure: testing.

• Cardiac/Catheter Ablation
• What to Expect at Cardiac/Catheter Ablation

Before Your MRI

Before your MRI we will draw blood. This blood helps us see if your kidneys are healthy and working the way they should. (Your will need your blood drawn one month before your MRI.) Please also follow these instructions:

• Do not drink any caffeine 24 hours before the scan.
• Remove all metal objects (such as glasses, jewelry, belts, or clothing with zipper).
• Fill out a pre-screening form.

Remember to dress comfortably. We will also ask you to change into a hospital gown.

After those things are done, an MRI tech will place an IV in your arm (possibly two). Please tell your doctor if you have any allergies to iodine or shellfish (contrast allergies).

You will need a 13-hour medication treatment before the MRI. Also tell your doctor if you are claustrophobic or if you get anxious in tight spaces. 

During the MRI, you will be lying on your back. We will try to make you as comfortable as possible. We will put a cushion under your knees and giving you a ball that you can squeeze in your hand. The ball will alert the technician, who runs the MRI machine, if you are feeling too uncomfortable or having any problems.

The MRI machine itself is loud. We will give you headphones so you can hear the technician who runs the machine. The technician will also use the headphones to give you instructions on how to breathe during certain parts of the scan. (Breath in, breath out, hold.)

If you are cold, we can get you a blanket. 

If your physician decides you can’t have a cardiac MRI, they may schedule you for a cardiac computed tomography (CT). This is also a non-invasive, painless test.

Implantable Pacemaker or Defibrillator

Note that even if you have an an implantable pacemaker or defibrillator , we can often still safely perform an MRI at University of Utah Health. However, the quality of the imaging may be lower than usual. We evaluate this on a case-by-case basis.

Transesophageal Echocardiogram (TEE): What Is TEE?

A transesophageal echocardiogram is a sonogram, and does not involve radiation. This sonogram allows your doctor to record images of your heart from inside your esophagus (food pipe).

This test looks for blood clots in your heart. It needs to be done 24–48 hours before your ablation procedure, but may instead be done as part of the ablation itself. If we find a clot in your heart, we will reschedule your ablation procedure.

Plan for the TEE to take one to two hours.

Before Your TEE

• Make a list of all your medications and check with your doctor to see if you can take them before the test.
• Don’t eat or drink for six hours before the test (this includes drinking water).
• Tell your doctor if you have ulcers, a hiatal hernia, or problems swallowing. Also, let him or her know of any allergies to any medications or sedatives.
• Plan for someone to drive you home after the exam.

During Your TEE

When you arrive for you TEE, you will change into a hospital gown. We will then take you to the testing room.

Once in the room, we will spray your throat with an anesthetic to numb it. We may also give you a mild sedative through an IV in your arm to help you relax. (You could also be given oxygen.) Then we will ask you to lay on your side.

The doctor will gently insert a probe into your mouth. As you swallow, your doctor will slowly guide the tube into your esophagus. We lubricate the tube is so that it will slide easily. You may feel the doctor moving the probe, but it shouldn’t hurt or interfere with your breathing.

A nurse will monitor your heart rate, blood pressure, and breathing. The test usually takes 20–40 minutes.

After the Test

If your TEE is the day before your ablation procedure, you can eat and drink again as soon as your throat isn’t numb. You will need someone available to drive you home after the test.

Preparing for Your Catheter Ablation Procedure

The night before.

Do not eat or drink anything after midnight on the night before your ablation.

• Take only medications your doctor has told you to take with a small sip of water.
• Remove makeup and fingernail polish.
• Do not wear perfume or lotions with any fragrance.
• If you wear glasses, contacts, or dentures, bring a case to store them in.

Things to Bring With You to Your Cardiac Ablation

• Work release form (if needed)
• Any heart medical records
• List of current medications or current medication bottles (This list should include the drug name, dose, and how often you should take it.)
• Any questions you may have
• Your insurance card(s) and ID picture

Day of the Procedure

Once you arrive at the hospital, a nurse will insert an IV into your arm to give you any medications and fluids that you will need during the procedure.

Because you will be receiving fluids from an IV, your nurse will sometimes place a Foley catheter into your bladder. The catheter drains urine during the procedure and recovery.

Your nurses will shave your groin area and neck so they can insert the catheters. (A catheter is a thin, narrow, flexible wire.) We will also place multiple patches on your chest and back. These patches will monitor your heart rhythm.

From here, your nurses will take you into the procedure room and move you onto to an X-ray table. The room will be cold, but we will do everything possible to make you comfortable. We will put blankets over you to keep you warm.

The patches on your chest and back will be connected to a machine. We will also monitor your blood pressure and oxygen level.

To keep the catheter insertion sites clean, we will cover your body with a sterile drape (cloth). Another sterile cloth will rest on your head, allowing you to still see the nurse. Only the area where the catheters are inserted will be exposed.

Your nurse or anesthesiologist will then give you sedation medication through your IV to help keep you comfortable. For some ablations, you will be under general anesthesia and on a breathing machine temporarily; for others you may be only lightly sedated and more awake. Your doctor and anesthesiologist will determine the best type of anesthesia to give you during your procedure.

The Cardiac Ablation Procedure

For some patients, doctors can perform an ablation without changing your heart's rhythm. However, more commonly, your doctor will use several catheters to cause your heart to beat quickly.

This will help your doctor create an electrical map of your heart. This map helps your doctor identify what type of arrhythmia you have and where the problem. Then they can find and ablate (or destroy) damaged cells inside your heart.

After ablating (destroying) the cells that are causing problems inside your heart tissue, your doctor will prompt your heart to start beating quickly again. If your heartbeat is regular and slower, then the ablation was successful. If your heart starts beating quickly and irregularly again, you may need more ablation.

Read more about what happens during cardiac ablation .

Inserting the Catheters

To insert the catheters into your skin, your doctor will use a local anesthetic to numb your skin so you won’t feel pain. However, you will feel a little pressure. Your doctor will use a small needle to make punctures in your veins or artery. If at any time you feel pain in the groin area, let the doctor or nurse know so they can inject more numbing medication.

Your doctor will then insert multiple catheters (or wires) through these puncture sites and guide them into your heart with the help of X-ray monitors.

How many catheters you have and where we place them will depend on the type of ablation procedure you're having.

The mapping catheter locates where the abnormal signals are coming from in your heart. It marks those places on our 3D-mapping computer system. This helps us find the areas inside your heart tissue that need to be ablated (destroyed).

The ablation catheter delivers radiofrequency heating energy (or freezing energy) to create lesions. These lesions disrupt the abnormal electrical signals inside your heart. You may feel some discomfort during this part of the ablation, depending on where in the heart it is. 

Often, doctors will use an intracardiac echocardiography (sonogram) through a special catheter from within the heart.

The total ablation procedure takes two to six hours, but the length of surgery depends on many factors.

During your procedure, we may ask you not to move or take deep breaths while your doctor is ablating. This is important so your doctor can make sure she is ablating the right areas.

After Your Procedure

When the procedure is finished, your doctor will remove all the catheters. They will put pressure on the areas where we inserted catheters. You will need to stay flat for two to six hours to make sure any bleeding has stopped and that your incisions (cuts) are healing well. Most patients will not need sutures (stitches).

After your procedure, you may stay at the hospital overnight so hospital staff can watch you.

Your doctor may give you a prescription before you leave the hospital. You may fill prescriptions at your regular pharmacy or the hospital pharmacy . If you would like to fill your prescriptions at the hospital, please remember to have your insurance card(s) with you as well as some form of payment.

Ablation Risks

The chances of having health problems after a catheter ablation are fairly low. Still, it’s important to discuss any possible problems you may have with your doctor before the procedure. 

Possible problems may include:

• bleeding from or damage to the blood vessels where catheters were inserted; damage to the heart itself;
• damage to the heart’s working electrical system;
• additional arrhythmias;
• irritation around the heart;
• stroke or heart attack; or
• collateral (associated) damage to nearby structures, such as the esophagus, pulmonary veins, and nerves that supply the diaphragm (phrenic nerve).

What To Expect After Your Cardiac Ablation

Common symptoms after ablation.

The ablated (or destroyed) areas of tissue inside your heart may take up to eight weeks to heal. You may still have arrhythmias (irregular heartbeats) during the first few weeks after your ablation. During this time, you may need anti-arrhythmic medications or other treatment. You may experience the following symptoms:

• Mild chest aches
• Skipping heartbeat
• Faster heartbeat

Contact your doctor if you experience any of the following:

• Increased bleeding
• Bruising or pain where your catheter was inserted (insertion sites)
• Shortness of breath or chest pain
• Coldness, swelling, or numbness in your arm or leg near the insertion site
• A bruise or lump that’s larger than a walnut close to where your catheter was inserted
• A fever of 100 F
• Symptoms of your arrhythmia
• Stroke symptoms

Recovery Guidelines

After your procedure you need to carefully return to your normal activities. These are general guidelines, but your doctor may modify them to suit your particular situation:

• Don’t drive for two days.
• Don’t lift more than 10 pounds for one week. (A gallon of milk is about 10 pounds.)
• Don’t exercise for one week.
• Don’t have sex for one week.

The evening of your procedure, we will ask you to start walking. In most cases, you can return to office work in two to three days.

Hear From Our Patients

In his late 20s, Parker Donat was an active guy known for his dedicated gym routine. By age 33, he was struggling to keep up with his wife Kristi during hikes—even when she had their small son strapped to her chest. Parker couldn't figure out why he was always "dogging it."

In addition to feeling worn out all the time, the young dad had another strange symptom: It often felt like his heart was beating in his throat. It was so bad, he'd get light-headed and he had trouble swallowing. It wasn't until he felt like he couldn't breathe and went to University of Utah Health's clinic in Farmington that he began to understand what was going on.  

Reasons for Your Racing Heart

When to See a Cardiologist

What to Expect at Your Cardiology Appointment

• Patient Care & Health Information
• Tests & Procedures
• Atrial fibrillation ablation

Atrial fibrillation ablation is a treatment for an irregular and often very fast heartbeat called atrial fibrillation (AFib). The treatment uses heat or cold energy to create tiny scars in an area of the heart. The signals that tell the heart to beat can't pass through scar tissue. So the treatment helps block faulty signals that cause AFib.

Atrial fibrillation ablation may be done if medicines or other treatments for AFib don't work. But sometimes it's the first treatment for certain people with AFib.

A doctor most often uses thin, flexible tubes called catheters to do atrial fibrillation ablation. The tubes are placed into blood vessels and guided to the heart. Less commonly, ablation is done during heart surgery.

• AV node ablation
• Maze procedure

Why it's done

• Atrial fibrillation

In a typical heart, a tiny group of cells at the sinus node sends out an electrical signal. The signal travels through the heart's upper chambers to the atrioventricular (AV) node. The signal then passes into the lower heart chambers, causing them to squeeze and pump out blood. In atrial fibrillation, electrical signals fire from many locations in the upper chambers, causing them to beat chaotically. Since the AV node doesn't prevent all of these chaotic signals from entering the lower chambers, the heart beats faster and irregularly.

Atrial fibrillation ablation is done to fix and prevent an irregular and often very fast type of heartbeat called AFib. You may need this treatment if you have a fast, fluttering heartbeat that doesn't get better with medicine or other treatments.

Possible atrial fibrillation ablation risks include:

• Bleeding or infection at the area where the catheters were placed.
• Blood vessel damage.
• Heart valve damage.
• New or worsening irregular heartbeats, called arrhythmias.
• Slow heart rate that could require a pacemaker to fix.
• Blood clots in the legs or lungs.
• Stroke or heart attack.
• Narrowing of the veins that carry blood between the lungs and heart, called pulmonary vein stenosis.
• Damage to the kidneys from dye, called contrast, used to see the arteries during the treatment.

Talk to your healthcare professional about the risks and benefits of atrial fibrillation ablation. Together you can decide whether the treatment is right for you.

How you prepare

You may have several tests to check your heart health.

Your healthcare team tells you how to prepare for atrial fibrillation ablation.

• You usually need to stop eating and drinking the night before the treatment.
• Tell your care team about all the medicines you take. The team tells you how or if you should take them before the treatment.

What you can expect

Atrial fibrillation ablation is done in a hospital. A member of your care team places an IV into your forearm or hand. You usually get medicines to help you relax. This is called sedation.

The amount of sedation needed for the treatment depends on the type of irregular heartbeat you have and your overall health. You may be fully awake or lightly sedated. Some people get a combination of medicines to put them in a sleep-like state. This is called general anesthesia.

• Catheter insertion points for cardiac ablation

During cardiac ablation, a thin, flexible tube called a catheter is passed through a blood vessel to reach the heart. More than one catheter is often used. The catheter may be inserted in the groin, the shoulder or the neck.

What happens during atrial fibrillation ablation depends on the specific treatment being done.

Most often, a doctor inserts one or more thin, flexible tubes called catheters into a blood vessel and guides them to the heart. These tubes are usually placed in a blood vessel in the groin, shoulder or neck.

Dye called contrast flows through the tube. The dye helps blood vessels show up more clearly on X-ray images.

The doctor uses one of the following ablation methods to create small scars in the heart. The scars block the irregular heartbeats:

• Heat energy, called radiofrequency energy.
• Extreme cold, called cryoablation.

You shouldn't feel any discomfort during the procedure. If you have bad pain or shortness of breath, tell your care team.

Atrial fibrillation ablation usually takes 3 to 6 hours. Complicated procedures may take longer. For example, if you have a type of atrial fibrillation ablation called AV node ablation, you need a permanent pacemaker to control your heart rate. The pacemaker may be placed before or during the ablation.

Another type of ablation to treat AFib is called the maze procedure. This type of ablation is done during open-heart surgery. The surgeon creates a pattern of scar tissue in the heart using a scalpel or device that delivers heat energy. The scars block irregular heart signals that cause atrial fibrillation.

After the procedure, you rest in a recovery area for a few hours. A care team closely checks on you. Depending on your condition, you may go home the same day or spend the night in the hospital. Plan to have someone drive you home.

Some people feel sore after atrial fibrillation ablation. The soreness shouldn't last more than a week. Most people can return to their daily activities within a few days. But ask your care team what activities are safe for you. In general, avoid heavy lifting for about a week.

Most people see improvements in their quality of life after atrial fibrillation ablation. But there's a chance that AFib may return. If this happens, another ablation may be done or your healthcare professional might suggest other treatments.

AFib is linked to stroke. Atrial fibrillation ablation hasn't been shown to reduce this risk. After ablation, you may need to take blood thinners to reduce your stroke risk.

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Atrial fibrillation ablation care at Mayo Clinic

• Bonow RO, et al., eds. Therapy for cardiac arrhythmias. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Feb. 2, 2021.
• Catheter ablation. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/catheter-ablation. Accessed Jan. 21, 2021.
• Zipes DP, et al., eds. Catheter ablation: Technical aspects. In: Cardiac Electrophysiology: From Cell to Bedside. 7th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed Feb. 2, 2021.
• Passman R, et al. Atrial fibrillation: Catheter ablation. http://www.uptodate.com/search. Accessed Dec. 18, 2023.
• Bonow RO, et al. Atrial fibrillation: Clinical features, mechanisms, and management. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Feb. 2, 2021
• January CT, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in collaboration with the Society of Thoracic Surgeons. Circulation. 2019; doi:10.1161/CIR.0000000000000665.
• Wang R, et al. Sudden death and its risk factors after atrioventricular junction ablation and pacemaker implantation in patients with atrial fibrillation. Clinical Cardiology. 2017; doi:10.1002/clc.22600.
• Calkins H, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace. 2018; doi:10.1093/europace/eux274.
• Lee R. Surgical ablation to prevent recurrent atrial fibrillation. https://www.uptodate.com/contents/search. Accessed Feb. 2, 2021.
• Knight BP, et al. Long-term outcomes after ablation for paroxysmal atrial fibrillation using the second-generation cryoballoon: Final results from STOP AF Post-Approval Study. JACC Clinical Electrophysiology. 2019; doi:10.1016/j.jacep.2018.11.006.
• Noseworthy PA, et al. Atrial fibrillation ablation in practice: Assessing CABANA generalizability. European Society of Cardiology. 2019; doi:10.1093/eurheartj/ehz085.
• What is an arrhythmia? National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/arrhythmias. Accessed Dec. 18, 2023.
• Deshpande S, et al. Impact of intracardiac echocardiography on readmission morbidity and mortality following atrial fibrillation ablation. Journal of Cardiovascular Electrophysiology. 2022; doi:10.1111/jce.15683.
• Ami TR. Allscripts EPSi. Mayo Clinic. Sept. 24, 2023.
• Packer DL, et al. Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation. JAMA. 2019; doi:10.1001/jama.2019.0693.
• Lévy S. Overview of catheter ablation of cardiac arrhythmias. https://www.uptodate.com/contents/search. Accessed Dec. 18, 2023.
• Noseworthy PA (expert opinion). Mayo Clinic. Feb. 5, 2021.
• Rowse PG (expert opinion). Mayo Clinic. Dec. 26, 2023.
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Flight safety in patients with arrhythmia

As it is comfortable, fast, and safe, an increasing number of patients with heart disease prefer to travel by flight. However, there is not much information about the problems that patients with arrhythmia may experience during air travel. In addition, the precautions to be taken with these patients during a flight are uncertain. In this review, the management of patients with cardiac conduction problems during flight was examined in detail.

Introduction

Nowadays, as it is safe, fast, and comfortable, more people prefer air travel; however, this is a stressful environment for the human body. According to the rules of the Federal Aviation Administration, the cabin pressure of a commercial aircraft should be kept below 8,000 feet ( 1 ), which corresponds to an altitude of 2,438 m and is considered the upper limit. The pressure at the height of 6,000–8,000 feet corresponds to approximately 0.16 of the oxygen fraction (FiO 2 ) inhaled at sea level ( 2 , 3 ). In addition, air at higher pressures contains lower humidity ( 4 ). These factors can worsen the condition of patients with arrhythmia.

The catecholamine level may increase owing to flight stress. In addition, some studies have shown that catecholamine levels increase during flight because of acute hypoxia ( 5 ). Increased sympathetic activation owing to acute hypoxia and increased catecholamine levels may increase the risk of cardiac arrhythmias ( 6 ). However, the incidence of significant arrhythmias during air travel is very rare. In a study of healthy male volunteers between the ages of 50 and 64, an increase in atrial and ventricular ectopic beats was reported with a sudden rise up to 2,632 m above sea level in a cable car. In addition, the frequency of ectopia has been proposed to be proportional to altitude. However, these findings were not found to be associated with an increase in sustained ventricular arrhythmia ( 7 ). In another study with healthy volunteers in a room that simulated the height of Mount Everest, researchers found that in proportion to the degree of hypoxia, heart rate increased, and temporal changes in the mean frontal QRS axis and voltage occurred ( 8 ). However, besides these findings, they observed that arrhythmic changes did not occur in electrocardiography (ECG) even in an environment where the oxygen saturation was 49%.

Air travel itself does not cause paroxysmal supraventricular tachycardia, atrial fibrillation, or atrial flutter. Patients who are asymptomatic or symptomatically stable should not be restricted from flying.

Patients with permanent or persistent atrial fibrillation can fly after adequate rate control and anticoagulation. Patients with a history of ventricular arrhythmia are advised to consult their doctor before air travel. However, those with uncontrolled ventricular or supraventricular arrhythmias should not be allowed to fly ( 9 ). As there is a small additional risk of thromboembolism during or after a flight, any passenger wishing to fly within 1 week of left or right-sided ablation therapy for arrhythmia should be considered as high risk for deep venous thrombosis/venous thromboembolism ( 10 ). As is known, implantation of cardiac electronic devices may be complicated by pneumothorax after subclavian vein puncture. It is generally followed conservatively, and rarely is any intervention required (0.6%–0.8%). Patients with pneumothorax have a risk of developing respiratory distress and tension pneumothorax because of the risk of gas expansion with altitude during a flight. Therefore, in a patient with pneumothorax complicating device implantation, the flight should be delayed for up to 2 weeks after full radiological resolution, regardless of whether intervention is required. If the cardiac device insertion has been uncomplicated, there is no absolute contraindication for the patient to fly 1–2 days following the procedure; however, a small increased risk of pneumothorax has been reported. In addition, as small pneumothoraxes may sometimes not be noticeable on chest radiographs, delaying flight for a while may provide time for spontaneous resolution. Patients should also be advised to restrict arm movements on the side of placing the device, avoid raising the elbow over the shoulder, and avoid heavy lifting to minimize the risk of lead displacement ( 10 ).

Patients with implantable heart defibrillators (ICD) are at the greatest risk for development of sustained ventricular arrhythmia during air travel. However, no case series with an increase in ICD shock incidence during the air travel of patients with ICD has been shown to date. There is also no study with an increased incidence of sustained atrial arrhythmia ( 11 , 12 ). It is still unknown whether hypoxia during air travel is associated with increased risk of sustained ventricular arrhythmia and implantable cardioverter defibrillator (ICD) activation in susceptible individuals. It has been proposed that profound hypoxemia induced by inhalation of a gas mixture containing 10% oxygen causes a significant and reversible increase in the pacing threshold ( 13 ). However, exposing 13 patients with implanted pacemakers to a hypobaric environment equivalent to 4000 m altitude did not cause any change in stimulation thresholds after 30 minutes ( 14 ).

Patients with arrhythmia should be careful about intake of liquids containing alcohol and caffeine during air travel, as it can contribute to dehydration in a less humid environment and can also interact with the drugs currently used ( 15 ). Discontinuation of treatment by leaving the medications in luggage in the cargo hold, especially during long air travel, may increase the risk of arrhythmia. Patients should keep the required medication in their hand luggage during travel. It may be useful to have their latest ECG with them. Patients with pacemaker and ICD should have their device cards with them.

According to the rules of the Federal Aviation Administration, which came into force on April 12, 2004, passenger aircraft with a maximum carrying capacity of 7,500 lbs and at least one flight crew must have an automated external defibrillator (AED) and emergency medical kit. All aircraft personnel should be trained in the usage of AEDs and in cardiopulmonary resuscitation. The rule came into force on April 12, 2004. In a study of data on AED use by one major US airline, Page et al. reported that the widespread availability of AEDs on commercial airlines might save the lives of 93 persons with ventricular fibrillation each year ( 16 ). In such patients, long-term survival rates range from 26% to 40%, compared with 2% to 5% long-term survival rates reported frequently for non-hospital arrests ( 16 – 18 ).

It is extremely rare for significant arrhythmias to occur during air travel, and air travel itself does not cause clinically significant arrhythmias. Patients with arrhythmia can travel by plane safely if they are asymptomatic or clinically stable.

Conflict of interest: None declared.

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Ablation Surgery: Recovery

Surgery follow-up, recovery timeline, coping with recovery, a word from verywell.

Your recovery, including how soon you can leave the hospital and return to work and the type of post-surgery care you need, may look different depending on which type of ablation surgery you had. In general, recovery from ablation surgeries is pretty quick and mainly involves pain and bleeding control. The road to recovering from an ablation surgery is usually fairly straightforward—avoid strenuous activities and heavy lifting while you are recovering from your surgery.

Verywell / Laura Porter

After your ablation surgery, your healthcare provider may choose to keep you in the hospital for a short time for observation. This happens most often with cardiac ablations or ablations done to the brain or spine.

With cardiac ablations, your healthcare provider will usually have you placed on a cardiac monitor overnight for observation. You will be watched for complications like:

• Bleeding or damage to the blood vessels where the ablation tools were inserted
• Bleeding or damage in the heart
• New or continuing arrhythmias
• Irritation or infection around the heart
• Heart attack
• Damage to structures around the areas affected by the ablation (nerves, veins, other organs)

For other types of ablation, including endometrial, bladder, and endovenous ablations, you can usually go home after the effects of anesthetics wear off. This can take anywhere from a few minutes to a few hours.

Follow-Up Appointments

Your healthcare provider would usually schedule a follow-up appointment for you regardless of what type of ablation surgery you had. You will receive instructions on when to call your healthcare provider and any special instructions to follow between your discharge and your follow-up appointment.

You may also have physical therapy appointments for more serious ablation procedures like cardiac or brain ablations. Endometrial and bladder ablations, or more superficial ablations for issues like varicose veins, require much less follow-up care and rarely need physical therapy.

The more vital the organ involved in the ablation surgery, the more follow-up care and physical therapy you will need.

Pain and Bleeding

In almost every type of ablation, you will need to watch for bleeding at the ablation site or from the area where the ablation was done. Your healthcare provider may also send you home with medications for post-surgery pain. You would normally experience pain at the site where ablation tools were inserted during the surgery:

• For cardiac ablation, the site is usually the groin, but can also be the neck
• With bladder or urethral ablations, a cytoscope is inserted through the urethra and you may experience some soreness
• During a brain ablation, a small hole is drilled into the skull for the ablation tools

For endometrial and endovenous ablation surgeries, which are less invasive than the surgeries listed above, you will still experience some pain and discomfort. Those who underwent endometrial ablation may have cramps or vaginal bleeding for several days after the procedure. They may also have watery vaginal discharge mixed with blood that should go away after a few days.

For those who had endovenous ablation, they may experience tenderness and bruising in the areas of the leg where local anesthesia was applied. Leg or ankle swelling, discoloration, and a pulling or tight sensation in the leg are also common with this type of ablation.

If you did not receive any prescription pain medications when you were discharged, the following tips may help with soreness and discomfort while you are recovering at home:

• Apply ice packs or a cold compress to the tender area
• Use over-the-counter-pain relievers like acetaminophen
• Ask your healthcare provider about taking ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) since these may increase the risk of postoperative bleeding
• Have throat lozenges or hot tea for relief if a breathing tube was used during anesthesia
• Wear support garments like compression socks for comfort and to help with healing—especially for endovenous ablations. Elevate the treated leg when in a rested position.

After your ablation surgery, you can generally return to life as usual—with some light restrictions. Mostly, you will want to avoid strenuous activities, at least for a short period of time.

You may be advised to:

• Avoid driving for two days after your surgery
• Avoid lifting anything heavier than 10 pounds for one week
• Avoid exercise for one week
• Refrain from sexual activity for one week, particularly with an endometrial ablation

In the first few days after your surgery, you may remain in the hospital if you had a brain or cardiac ablation surgery. For others like urethral or venous ablations, you will likely be sent home the same day the procedure is done. The first few days after you go home should be spent resting and limiting activity. Specifically, you should avoid lifting heavy objects or straining since this could herniate or tear the area where your ablation was done.

In the weeks after your ablation, you will return to life as normal. Even with a cardiac ablation—one of the more involved ablation procedures—you should be able to go back to work within a few days.

You may still experience effects from your ablation a few weeks after your procedure, including a change in heart rhythm with a cardiac ablation or ongoing bleeding after endometrial ablation. In the case of cardiac ablation, these effects can be managed with the help of your healthcare provider.

In many cases, knowing whether an ablation worked takes time. For example, with cardiac and venous ablations, you will want to to see if the condition persists or recurs.

When to See a Healthcare Provider

Certain signs during your recovery may indicate that you need immediate medical assistance. They will also be different depending on which type of ablation surgery you had.

For cardiac ablation:

• Increased bleeding
• Shortness of breath or chest pain
• Swelling or numbness near your insertion site
• A bruise or lump the size of a walnut near your insertion site
• Symptoms of arrhythmia
• Stroke Symptoms

For brain ablation:

• Signs of infection like a fever

For bladder ablation:

• Inability to keep fluids down
• Red urine or blood clots in your urine
• Trouble passing urine or stool
• Signs of a blood clot such as redness and swelling near the groin

For endometrial ablations:

• Persisting pain even after taking pain medications
• Inability to pass stool or gas
• Increased vaginal discharge
• Signs of an infection like a fever

For endovenous ablations:

• Bleeding at the site where the catheter was inserted
• Numbness in your calf, foot, or leg

As you recover, you may need help with some tasks, especially those that require lifting heavy objects. You will also need someone to drive you home from the hospital and anywhere else you need to go for a few days.

In many cases, you will see your condition improve after your ablation surgery. Other times, you may experience complications or new problems. Make sure you have a support system in place, and discuss what to expect with your healthcare provider before your ablation.

When your ablation is done, your condition will usually be resolved. In the case of cardiac ablations, irregular rhythms may return if you have chronic health problems. How well your condition you received an ablation for is cured depends a lot on what caused your condition in the first place.

Talk to your healthcare provider about how you are handling your disease mentally and emotionally. Consider joining a support group for people with your condition or counseling with a professional who can help you cope with your condition.

The incisions made for your ablation catheter are small and don’t require stitches in most cases. The incisions will be closed with adhesive strips or glue. Your healthcare provider may suggest that you avoid baths or swimming until the incisions have healed well.

You will be instructed to call your healthcare provider if you notice any of the following symptoms:

• Redness at the incision site
• Swelling at the incision site
• Drainage or bleeding from the incision site
• Increased pain

You usually don’t have to leave the post-op dressing on once you go home, but you may wish to cover the incision with a dry bandage if you have any drainage or want to protect the site.

If you have a sizable incision or go home with a dressing on your ablation site, here are some tips for wound care once you go home:

• Always wash your hands before touching your incision or the area around it
• Leave adhesive dressings on the incision like Steri-Strips in place. These will fall off on their own within two weeks. If they are still on after two weeks, you may gently remove them
• If your incision was closed with dissolving stitches, these will disappear on their own. If you had sutures or staples, your healthcare provider will give you instructions on when these can be removed
• Don't pull, tug, or rub at any incision closures.You can usually shower within 24 hours, but cleanse these areas gently with water and mild soapy water. Do not rub
• Do not use solutions like alcohol or peroxide to clean the wound since they can dry your wound out and extend the healing process
• Look for increased bleeding, redness, or discharge from the wound site, and call your healthcare provider with any questions
• Don't use ointments or creams on your incision unless you are instructed to do so by your healthcare provider
• If you want to apply a new dressing to your incision to protect it or to collect drainage, use a dry piece of clean gauze and tape it to the site. Do not apply tape to the incision itself

Ablations are generally simple procedures with a short hospital stay and recovery process. The key to recovering well from ablation surgeries is to take a few days to rest up before resuming normal daily activities. Don't push yourself after the procedure, and enlist your friends and family to help you get around or with chores while you are recovering.

University of Utah Health. What To Expect Before, During, & After Cardiac Ablation.

Mayo Clinic. Transurethral Needle Ablations .

Johns Hopkins. MRI-Guided Laser Ablation for Brain Tumors .

John Hopkins Medicine. Endometrometrial Ablation .

Penn Medicine. Ablation Recovery: What You Should Know .

Cleveland Clinic. Catheter Ablation: Procedure Details.

Cleveland Clinic. Incision Care: Procedure Details .

By Rachael Zimlich, BSN, RN Zimlich is a critical care nurse who has been writing about health care and clinical developments for over 10 years.

Top 10 Things to Expect After AFib Ablation

Thanks to strides in Cardiac Ablation Therapy, countless people who suffer from atrial fibrillation (AFib) have been able to get the help they need through a minimally invasive procedure. Although the recovery time after an ablation procedure is significantly less than that of open heart surgery, there are still some things to keep in mind in the weeks and months after you leave the hospital. Below are 10 of the top things to expect after your AFib ablation .

• The recovery time depends on many individual factors, so make sure you allow your body to recover at its own pace. Even though it is a minimally invasive procedure, you still need to make sure you don’t over stress your body as its recovering.
• Because the catheter is inserted in the groin area, there can be some pain and bruising in the days after the procedure. However, if the pain is persistent or there is swelling, contact your doctor.
• Chest pain after the procedure is common, especially when taking a deep breath or coughing. This is because the lining of the heart can be irritated by the procedure, but the pain levels should decrease as the days go on.
• Arrhythmia isn’t uncommon. You’re not going to leave the hospital with a heart that beats perfectly right away. It may speed up, slow down, or even exhibit AFib again for a few weeks, but this is part of the process of your heart getting used to a new rhythm.
• Effects from anesthesia are normal. You might have a sore throat or coughing, and you might feel groggy for hours or even days after the procedure.
• Your resting heart rate will likely increase. It will go up 10-20 beats per minute for a few months, then will likely settle into a lower rhythm after that.
• Your tolerance to exercise will go down for a period of weeks to months. Your heart’s been through a serious procedure, so be sure to give it time to rest and recover.
• Edema, or water retention may occur in the days and weeks after. This is usually caused by the saline solution sent into your body during and after the procedure. A few days of drinking good amounts of plain water will clear out the excess sodium in your system, as well as the water that it’s causing you to retain.
• You may have some digestive problems. Acid reflux, inability to eat large meals, and feeling bloated are all common. Switch to smaller meals for the time being, and take an over-the-counter acid blocker when needed.
• You can’t throw away your AFib medication right away. You’ll be on anti-coagulant drugs and probably medication to regulate your heart’s rhythm, so be sure to ask your cardiologist about your medication options afterward.

As a highly specialized electrophysiologist, Dr. Dilip Mathew has performed more ablation procedures than anyone else in the Sarasota or Venice area. He has taken special interest in cardiac ablation therapy and other modern techniques that improve heart health, including being the first cardiologist in West Florida to perform the LARIAT™ Procedure. If you are considering a cardiac ablation or if your primary care physician recommends seeing a cardiologist, contact Dr. Mathew today.

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About heart rhythm consultants, p.a..

The experienced electrophysiologists of Heart Rhythm Consultants, P.A. have been serving West Florida including Sarasota, Venice, Tampa, and Sun City Center for over 15 years. Our specialty cardiologists, or EP doctors, help patients manage their abnormal heart rhythm conditions, whether they suffer from arrhythmias like atrial fibrillation (AFib), or other irregular heartbeats. Dr. Dilip J. Mathew and Dr. Rajesh Malik perform arrhythmia treatments like cardiac ablation, cryoablation, and implanting pacemakers or defibrillators. Dr. Mathew has performed nearly 5,000 complex cardiac ablations. View our office locations in Sarasota and Venice, Florida.

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Table of Contents

Read more about what to do if you have AFib after ablation in this article. There are many people that continue to struggle with episodes of atrial fibrillation, even despite past procedures such as an ablation . Many people have gone through this, and perhaps you have gone through this too, where you have already gone through an experience of an ablation procedure, you went through sometimes a challenging recovery period as well, and then afterwards find that you are still having episodes of atrial fibrillation . Hopefully the symptoms are better than it was prior to the ablation, but it’s possible that your control is not as satisfactory as you would like it to be.

Can Atrial Fibrillation Come Back After Ablation?

In this article I will discuss some of the reasons why people still have AFib after an ablation procedure, and what you can do to help improve your success rate of an ablation procedure. When it comes to the reasons why an ablation procedure does not work, I’ll divide it up into technical failures as well as what I would call “missing pieces of the puzzle.”

 When it comes to technical failures, that basically means that there was an incompleteness or an issue with the actual ablation procedure itself. It can be because areas grow back from the original procedure, which I’m going to discuss more below, or it could be that not enough was ablated at that time.

Technical Issues With Pulmonary Vein Isolation

Let’s first talk about areas of the heart tissue growing back after an ablation. Now, universally for most people’s atrial fibrillation, the main target for ablation is an area called the pulmonary veins , which is located in the left atrium, or left upper chamber of the heart. The pulmonary veins are where most people’s AFib comes from, and this is the most common area in the heart that triggers episodes of atrial fibrillation . If you’d like to know more about what happens during a catheter ablation for atrial fibrillation, including pulmonary vein isolation,check out my article about the  AFib ablation procedure details. But as far as the procedure itself, targeting and ablating the areas around the pulmonary veins in order to block the short circuit signals that trigger episodes of AFib, is the most common goal for an AFib ablation.

However, in past clinical studies when they have looked at people who have had recurrences of AFib , meaning AFib that comes back after ablation, in those settings where the patients end up getting another ablation procedure, a common thing that is found is that pulmonary veins have reconnected or the heart tissue has grown back. So why would a pulmonary vein reconnect after it’s already been ablated? Well, the heart can be amazingly resilient, and even though during an ablation procedure, it’s the electrophysiologist’s goal to actually to intentionally burn or create scar areas of the heart in order to reduce AFib. The heart can be amazingly resilient and actually grow back, and there’s a few reasons that that can happen.

During an ablation procedure, the electrophysiologist can see if the normal heart signals that he’s trying to ablate have been successfully ablated, and that’s fairly simple to see an ablation catheter. However, what might be happening is that the tissue that is trying to be ablated is not thoroughly and completely ablated, it may just be stunned or swollen to where it hasn’t been completely ablated. Then over time, usually over a period of several weeks, that swelling subsides and then the tissue reconnects and goes back to normal, this is the main way that sometimes heart tissue can grow back.

Now over the years, the technology that is used during an ablation, in order to have more thorough ablation lesions, and to prevent the areas from coming back is always continuing to improve and change. I frequently mention to my patients that the equipment to do ablation procedures, changes every year like an iPhone does, there’s always new models and new versions of equipment that are coming out in order to try to improve the success rate. Most importantly, over the last few years, several of the ablation catheters now have what is called contact sensing. It basically gives a feedback to the doctor to know how strong the catheter is touching the heart. You can imagine how difficult it can be to get good contact with a beating heart while you’re trying to do a procedure on someone, and so these sensors have allowed doctors to get better contact with the heart tissue, as well as hopefully provide more thorough ablation lesions.

A second reason for technical failure is, I would say is a “knowledge deficit.” This is more important for people who are in more advanced stages of atrial fibrillation . As I have mentioned in the past, AFib is a disease that progresses over time, if you want to learn more about stages of AFib, check my article on the progression of AFib. Atrial fibrillation is a disease that progresses, it inherently changes the microscopic features inside of the heart and inside of the left atrium where AFib usually comes from. As people get more and more episodes of atrial fibrillation, especially people who are in an AFib all the time or most of the time, there tends to be a lot of scar tissue, or fibrosis, inside of the left atrium. As a result, as people develop more advanced stages of atrial fibrillation, the routine ablation, which involves only ablating around the pulmonary veins, may not be sufficient enough just because the heart has changed so much after all the episodes of AFib and all the duration of a patient’s AFib

Many times in patients with more advanced AFib, an ablation procedure will frequently require an ablation that is more than just the pulmonary veins in order to get a better success rate. However, what defines that “more ablation is needed” is something that does not have a clear consensus about what to do at this time. There have been many research studies over the years about strategies on how to ablate people who are in more advanced stages of AFib, and unfortunately all the research results don’t give any clear consensus. That is why the strategy to ablate someone’s AFib who was in more advanced stages of AFib, is pretty much based on what your doctor’s preferences are, as well as your doctors past experience. But there is no clear standard definition that says all doctors or all electrophysiologists should ablate this amount or not this amount when someone is in more advanced stages of a AFib. Despite many past research studies, there has been no clear consensus. AFib changes people’s hearts very differently, and one heart is different than another, which is in my opinion, part of the reason why there’s been no clear consensus.

In my opinion, what’s going to give people with more advanced stages of AFib better results is going to be to customize their AFib ablation, meaning having a good strategy to most determine what, in an individual patient, are the areas that need to be ablated. This is easier said than done, again, there have been many research studies which have clearly not giving an answer to this question at this point. Some of the past clinical studies involve very complex mathematical models to try to figure out what in each individual patient is causing each individual patient’s AFib. But again, still no clear consensus, but I am convinced that someday there will be a clear, simple, straightforward way for any electrophysiologist to figure out what are the most necessary areas to ablate for a person with advanced AFib to improve their success rate, in a customized fashion.

How Else Can I Improve The Success Rate of An AFib Ablation?

Another reason why some people exeprience AFib after an ablation is what I would call: “missing pieces of the puzzle.” There are many factors that are outside of the ablation itself which have been found to improve the success rate of the ablation procedure as well. Most of these are involved in the category of lifestyle modifications or managing other health conditions. Probably one of the most studied lifestyle modification that can also improve AFib ablation is weight loss . Weight loss had been found to significantly improve AFib, but it has also been found to improve AFib in the setting of a catheter ablation, to improve the success rate of the ablation itself.

When patients are overweight they are also at increased risk for high blood pressure and diabetes, which can also contribute AFib, as well as increasing the scar tissue in the left atrium. However, the fat molecules themselves, whether that’s fat molecules around the waist or even fat molecules that develop around the heart tissue, can all secrete hormones which increase inflammation, which can then in turn continue to lead to progressions of AFib. That is a reason why weight loss has been shown to have significant improvement in AFib. And one of the biggest diet studies to date called the LEGACY trial.

During the LEGACY trial, patients who got an ablation procedure and lost weight, ideally over 10% of the initial starting weight, had the highest success rates from the ablation procedure, versus people who got an ablation procedure but did not lose any weight or did not change their lifestyle, did not have a very good success rate. This can be a clue in terms of why doesn’t a procedure work sometimes, that more things need to be done than just the ablation procedure itself. Clearly an ablation procedure combined with the right lifestyle modifications can make a dramatic and significant improvement in person’s AFib, as well as improving the success rate of the procedure itself.

Another topic that has been shown to have significant improvement AFib as well as having a significant improvement in the success rate of an ablation procedure, is management of sleep apnea. Sleep apnea also happens to be strongly correlated with obesity. In sleep apnea, patients frequently stopping breathing while they are asleep, and that can happen many times and there has been a very clear association with sleep apnea with atrial fibrillation, as well as improving the success rate of an ablation procedure with sleep apnea treatment. There’ve been studies that have clearly shown that if someone has an ablation procedure and also is properly being treated for sleep apnea, if they have it, then that person is going to have a higher success rate from the ablation procedure as well. If you’d like to read more about sleep apnea and how it affects AFib, check out my article on sleep apnea and atrial fibrillation.

Weight loss and sleep apnea are probably the most commonly studied, in terms of lifestyle modifications or other health conditions where that improving those health conditions can also make a significant improvement in someone’s AFib, as well as improving the success rate of an AFib ablation procedure. But there are also other health conditions which can also show improvement which include strict management of high blood pressure, diabetes, also evaluation and need for any treatment for thyroid related disorders just to name a few. But I would discuss with your doctor which additional lifestyle modifications may be needed for you.

So what tips can I give to someone who continues to experience AFib even after an ablation procedure? In my opinion, it would be best to start off with the lifestyle modifications such as those listed above first, weight loss or treating sleep apnea may make a huge difference in improving AFIb symptoms. Many patients get multiple ablation procedures performed because an underlying health condition is not properly treated. If none of these lifestyle medications apply to you, sometimes additional ablation procedures will be needed. Always discuss with your doctor which treatment options are right for you.

Hopefully this article can be helpful for you if you’ve had an ablation procedure and still struggle with symptoms of AFib, please discuss with your doctor what are the right treatment options for you. In addition, if you’re looking for an online program to help you with implementing these lifestyle modifications to your life and improving the success rate from any ablation procedures, check out my program, Take Control Over AFib.

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Air travel after ablation?: We spend a... - Atrial Fibrillati...

Atrial fibrillation support, air travel after ablation.

We spend a lot of time away in the winter & my hubby so looks forward to it.I have an ablation scheduled and wondered how advisable it is to fly asap after published 4 weeks.And although I am very much a person who needs to organize my life I know AF doesn't allow this and will see how things are and book last minute.

I am quite expecting it may not work or not even happen as told only 50% chance .

Just looking for people's thoughts & maybe experience.

After ablation, it is common for patients to be advised to take a few weeks to rest and recover before air travel. The timeline for recovery can vary based on the individual and the specifics of the procedure, but generally, it's recommended to wait AT LEAST 4 weeks before flying.

However, it's important to keep in mind that we are all different and every person's recovery time is also different. Before making any travel plans, I think it's best to check with your doctor to discuss this matter. Personally, I would wait at least a few months before flying after an ablation - that's just me though and you may be fine. You'll likely pay more for a last-minute booking but your health comes first. I wish you a successful recovery. Soak up some sun for me if you do get away.

I was told to wait a couple of weeks, but best to check with your ep, as they know what is involved in your specific procedure, as well as your medical history. But if you do plan on flying close to the permission date they give you, think about traveler's insurance in case you have complications that would delay flying safely.

I flew 5 days after ablation, my EP said he would prefer I waited 2 weeks but that some of his patients flew day or two following with no complications.

I think it’s so individual and you really won’t know till it’s done how you will be so I’d agree with getting good insurance if you book anything prior to having ablation - ifvyou are waiting for a procedure you may find it difficult to be honest. I flew because I was living in Spain at the time so had to return home.

Thanks CDreamer.Impossible to get insurance for existing illnesses for 15 months as waiting for Cv then awaiting ablation.Main worry for me is if something happens on the plane.I sometimes wonder if having a holiday home is worth it anymore . Usually too hot for me from May onwards so can only do 90 days between end of Oct & Apr.

Keep hoping I can get AF sorted & spend more time there.

Keep saying this time next year I will be better.

It’s not impossible but it is difficult and may be expensive so depends upon how deep your pocket is and how much you want to go. What I did when just going to our Spanish holiday home was to take out annual medical insurance locally, didn’t bother about the cost of the flight, that worked.

I’ve been in AF on planes several time and it’s really no big deal - as long as you have plan, don’t stress and stay really well hydrated and don’t tell any of the crew! Stressing about it is the worst and most likely to bring on an episode. I worried more about getting through the airport and the long queues as I can’t stand.

I guess it can wait & something tells me the need to have this conversation is to stop me worrying about the ablation.Think a point in time after the ablation.Scheduled for 22nd.Hope saying the date doesn't jinx it.

Travel insurance maybe be an issue depending on your age and any pre-existing conditions and where you're travelling to usually ok with in the EU area.. long haul is another matter, best get travel advice from your consultant also how quickly you start recovery it will vary from person to person, I had a wound in my groin for a number of weeks after so was grounded for around a month

I was advised after my recent ablation not to go away for 1 to 2 months in case of complications.

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