1. Q. What doctor is going to do the procedure?

A. Drs. Gula, Klein, Krahn, Leong-Sit, Skanes and Yee are the 6 staff cardiologists in charge. The doctors work as a team and as a result, any one of the doctors could be doing your procedure. Even though a particular doctor may have seen you in our offsite clinic, he may not be the same one actually doing the procedure. At least one other doctor working with the cardiologist as well as several nurses and technicians assist in the procedure also.

2. Q. When can I go back to work or get involved with heavy exercise?

A. We will give you firm instructions after the procedure. However, we want people to return to normal physical activity as quickly after the procedure as possible with the exception of vigorous activity or heavy lifting. Generally we ask that people avoid such activities for seven days after the procedure. People often return to school or to a job that involves light physical activity the following day.

3. Q. Will the doctors write a note or fill out health care forms for being off work?

A. We ask that patients bring in any health care forms from their work setting and we will be glad to fill them out or write a note as is needed.

4. Q. I live a long distance from London. When can I go back home?

A. Those who fly to London may go back by airplane the following day but we generally recommend that they book a flight two days after the procedure. People generally are discharged the same day but sometimes we have to keep people in overnight, discharging them the following day which could make it difficult to catch a flight the day after the procedure. Those who travel by car from up to three hours away are usually able to go back home immediately after being discharged. Those who live further away may find it is more comfortable to stay in London the night of the procedure and travel the following day. Our general recommendation for anyone after a procedure is to avoid sitting in one position for longer than an hour. Get up and walk around at least once an hour during car rides and keep yourself well hydrated.

5. Q. Will there be any discomfort or pain related to the procedure?

A. You can expect some pain when the local anesthetic (‘freezing’) is injected into the skin to numb the area before catheters are introduced into the blood vessels in your leg and somtimes under the collarbone. People can expect to have some form of discomfort due to the ablation. Some describe the discomfort during ablation in keeping with a generalized aching sensation deep in their chest. Others describe it as a pressure-like sensation or gripping sensation in their chest. These sensations may linger for a couple of days after the procedure. However, there are many people who have an ablation and don’t feel any discomfort at all.

6. Q. Will I stay overnight?

A. Most ablations are a one day procedure. We do, however, ask that people bring an overnight bag in case of the need for an overnight stay.

7. Q. Will I be asleep for the procedure?

A. People do not usually need to be anesthetized or asleep for this type of procedure. However, we want to make sure that you are comfortable during the procedure and we will give sedative medications through the intravenous that will make you sleepy. Most people are asleep during the procedure but might be vaguely aware of some things going on during the procedure. There may be an anesthetist involved with the procedure but that does not necessarily mean that a patient will be completely asleep.

8. Q. Can I bring a Walkman in to help me relax during the procedure.

A. Yes, this is a very good idea.

9.Q. Should I avoid minor surgery before the procedure?

A. This should not interfere with the procedure. However, if there is any risk for infection as a result of the minor procedure or surgery it may lead to postponement of the ablation until the infection clears.

10. Q. Can a family member or friend be with me during the procedure?

A. No, for reasons of safety and infection control we cannot accommodate extra people in the procedure room.  Your family and friends will be directed to a comfortable waiting room and then may join you in the ‘short stay unit’ after the procedure.

12. Q. Will they use a vein or artery?

A. We always using the right leg vein and likely the vein under the left collarbone for the procedure. For some procedures we need to use the leg artery on either side.

13. Q. Will students be involved with our procedure?

A. We do have Arrhythmia Fellows who assist in the procedure. They are fully trained cardiologists who are specializing in Arrhythmia management. Medical students occasionally are present to observe only.

14. Q. What should I do if my heart races while I am off the medication in preparation for the procedure?

A. It depends on how you feel and what your past history has been with the heart racing. If your episodes are generally well tolerated and self limiting, nothing more needs to be done. There are no restrictions on how a physician can treat your tachycardia in light of procedure planning. For example, we have had people go to the Emergency Department to have their tachycardia terminated three hours before their procedure. It is important to realize that the chance of having tachycardia while off your medications in preparation for the procedure is unlikely but possible.  However, stopping medication as directed improves the likelihood that the procedure will be successful.

15.Q. Why do I have to be off my medications in preparation for the procedure?

A. Some medications will prevent us from “seeing” the electrical problem causing your tachycardia, and may prevent us from being able to fully determine the mechanism of your heart racing problem. As a result in some cases, no ablation can be carried out because of the effects of medications on your electrical system.

16.Q. Will I be able to stop my medications after a successful ablation?

A. Yes. Any medications you were prescribed solely for your tachycardia can be stopped if the ablation is successful. Any medication you are taking for other conditions like high blood pressure or angina would need to be continued and may need to be adjusted.

17.Q. Will I be on any medications after the procedure?

A. We generally recommend a 325mg Aspirin daily for three months after an ablation procedure. If you develop problems from the Aspirin during this three month period, we recommend that you then stop the Aspirin. If you are allergic to Aspirin we will discuss whether we would suggest a different type of blood thinning medication.

18.Q. What type of follow-up will be required after the procedure?

A. Generally we recommend that patients contact their family doctor’s office to arrange to have a 12 lead ECG done three months after the procedure and that a copy of the ECG is sent to us for our records.  Depending on the details of the procedure, we may suggest follow-up at our clinic but this is not always necessary.

19.Q. Can I have recurrence of my tachycardia after a successful ablation?

A. Patients may experience sensations of flip flops, heart pounding or a fluttering sensation after an ablation and this is considered perfectly normal. If a person finds that their heart is racing and they feel that it is the same problem as before the ablation, we ask that people go to their nearest walk-in clinic, Emergency Department or family doctor’s office to get an electrocardiogram recording during their palpitations. Rarely, people can have recurrence of their original problem after what had been an apparently successful ablation. This occurs roughly in 5% of patients and in such cases a second procedure may be necessary. If you were taking medications before the ablation procedure and and have a recurrence of tachycardia after the ablation, we recommend that you contact your family or local doctor before re-starting medication(s).

20. Q. Where can my family or I stay while visiting London?

A. Many people have family in the vicinity they can stay with. Those who do not may choose to book a hotel room privately as there are several hotels in close proximity to the hospital. We recommend you book reservations early to ensure availability. Many hotels offer a corporate discount to families coming for procedures at London Health Sciences center so please remember to ask when booking. For those with limited means, the Sisters of St. Joseph offer a hostel facility (Mount St. Joseph Mother House – 1486 Richmond St. – phone number: (519) 432-3781 that is two blocks from the hospital at very reasonable daily rates.