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

A. Drs. Gula, Klein, Krahn, Skanes and Yee are the 5 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 technician 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, as a rule of thumb, we want people to return to normal physical activity as quickly after the procedure as possible with the exception of prolonged standing and sitting or heavy lifting. Generally we ask that people avoid such activities for two to seven days after the procedure. For example people often go back to school the following day or to a job that involves light physical activity.

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 would make it difficult to catch a flight the day after the procedure. Those who travel by car from two 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 frequently when you are awake and keeping yourself hydrated.

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

A. You can expect some pain when the local anesthetic (dental-type freezing) is injected into the skin to numb the area before catheters are introduced into the blood vessels in your leg or under the collarbone. People can expect to have some form of discomfort due to the ablation. People will describe the discomfort of ablation in keeping with a generalized aching sensation deep in their chest. Others will describe it as a pressure-like sensation or gripping sensation in their chest. People who do feel this will find that it may linger for a couple of days after the procedure. There are other people who have an ablation and don’t feel any discomfort at all related to the ablation.

6. Q. Will I stay overnight?

A. Most ablations are considered a one day procedure. We do, however, ask that people bring an overnight bag in case we do have to watch people overnight.

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

A. People do not have to be anesthetized or put to sleep for this type of procedure. However, we want to make sure that people are comfortable during the procedure and we will give them sedative medications through the intravenous that will make them 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 put to sleep for the procedure. Most anesthetists will keep people well sedated. If an anesthetist is involved with the sedation then a patient will go to the Recovery Room for roughly an hour before they finish recovery up on the floor.

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

A. Yes, you may.

9. Q. I have a tongue piercing. Do I have to remove it for the procedure?

A. This depends on the anesthetist. Some may wish for you to remove it. If in doubt, take it out.

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

A. As a rule of thumb, 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 cancellation of the ablation until the infection clears.

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

A. No.

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

A. We always using the right groin vein and likely the left shoulder vein for the procedure. We can be in a situation where we might use the groin artery on either the right side or the left side if needed.

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

A. We do have electrophysiology fellows who assist in the procedure. They are trained cardiologists who are specializing in this field of Arrhythmia therapy. 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 all depends on how you feel and what your past history has been with the heart racing episode. If your episodes are generally well tolerated and self limiting, nothing more needs to be done. If you find that you are unwell with your palpitations, then present to your local Emergency Department informing them why you are off medication and they will treat it as is required. There are no restrictions as to how a physician can treat your tachycardia in light of having the planned procedure done. 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.



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. Other medications will prevent us from being able to fully understand 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. Of course, any pill you are taking for other conditions like high blood pressure or angina would need to be continued and maybe even adjusted.

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

A. We generally recommend an Aspirin a day for three months as a result of the ablation procedure, recommending enteric coated ASA 325 mg once a day for three months. If a person develops problems being on Aspirin during this three month period, we recommend that they stop the Aspirin. If you are allergic to Aspirin we will discuss whether we would put you on 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 get sent to us for our records. People who live close to London may ask for a follow-up appointment with the Arrhythmia Service at the time of discharge if they wish.

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 of their palpitations. People can have recurrence of their original problem after what had been an apparently successful ablation. This occurs roughly in 5% of people and in those situations 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 often 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 block from the hospital at very reasonable daily rates.