Information for patients before and after a heart rhythm study (electrophysiology study, or EP study) or catheter ablation.
Answers come only from this guide. This tool does not replace advice from your care team. In an emergency, call 911.
Enter your procedure date to see what happens and what to do, from a month before your ablation to 3 months after. You can add the dates and reminders to your own calendar.
Nothing you enter here is sent to the hospital or anyone else. It stays on this device.
Built from the answers in this guide. Sources: 3, 4, 6, 8, 9, 12, 16
An EP study is a heart catheterization done to diagnose a heart rhythm problem with certainty. A catheter ablation is the treatment step that follows, based on what the EP study finds.
Abnormal heart rhythms come from faulty electrical signals, or "short circuits." During an ablation, thin tubes called catheters are guided to the heart, and a small area of scar is made where the signals go wrong. This breaks the faulty electrical circuit so the heart can return to a normal rhythm.
Sources: 1, 2, 6
Ablation can treat most types of fast heart rhythms, including:
Ablation is often recommended when a rhythm causes symptoms, is life threatening, or is not controlled by medication, or when medicines cause side effects that are hard to manage. For some rhythms, it may be one of the first treatments offered.
Sources: 5, 7
Three types of energy can be used to create the small scars that block abnormal signals:
The scars are made only in carefully chosen areas involved in the abnormal rhythm. They do not cause ongoing pain or affect how well your heart pumps.
Sources: 5, 6
To confirm the diagnosis of a heart rhythm problem and to find abnormalities in the heart's electrical system.
Source: 1
No. It is considered a relatively minor, minimally invasive procedure. The catheters reach the heart through a vein, usually in the groin and sometimes in the arm, leg or neck, so there is no open surgery. Risks and recovery time are lower than with open surgery.
Source: 2
In most cases, no. Our program uses ultrasound and a three-dimensional (3D) mapping system to guide the catheters instead of X-ray.
Source: 3
A diagnostic EP study, which records and paces the heart's electrical system, is considered very low risk. Some people get bruising where the intravenous (IV) tubes were placed.
An EP study is different from a coronary angiogram. It does not carry the angiogram's risks to the heart arteries, such as stroke, heart attack, kidney damage, or the need for urgent bypass surgery.
If an ablation is done, the risk stays low and depends on which rhythm is being treated. Your electrophysiologist will review your specific situation with you.
Source: 1
The most common problem by far is bruising or bleeding where the intravenous (IV) tubes were placed in the leg. This is managed with firm pressure on the site and proper dressings.
Overall risk depends on the rhythm being treated. Any ablation could, in theory, make a small hole in the heart that causes bleeding into the sac around it (the pericardium), but this is extremely rare.
Other rare risks include blood clots, injury to the blood vessel where the catheter went in, injury to the heart tissue or heart valves, infection, a new or worsening irregular heartbeat, and a slow heart rate that may need a pacemaker. Complications are less common at hospitals that do a high number of ablations. Your team watches your heart rhythm, blood pressure and puncture site closely during and after the procedure, so any problem can be found and treated quickly.
For atrial fibrillation ablation risks, see the atrial fibrillation section. Your electrophysiologist will go over all of this with you at your clinic visit.
Sources: 1, 5, 7
For most fast heart rhythms, ablation is a very effective treatment. Success depends on the type of rhythm:
| Supraventricular tachycardia (SVT) | About 90 to 95% |
| Typical atrial flutter | About 90 to 95% or more |
| Atypical (left-sided) atrial flutter | About 70 to 75% after a first procedure |
| Paroxysmal atrial fibrillation (comes and goes) | About 80% |
| Persistent atrial fibrillation (does not stop on its own) | About 60% |
| Atrial tachycardia, ventricular tachycardia (VT) | About 60 to 80% |
If the rhythm continues or comes back, a second procedure may be needed. After atrial fibrillation ablation, about 10% of people need a repeat procedure.
For atrial fibrillation, even when episodes are not completely eliminated, ablation can reduce how often they happen and how long they last, ease symptoms and improve quality of life compared with medicines alone.
Sources: 3, 5, 7, 16
Ablation has not been shown to increase life expectancy for everyone who has it. For some people with both atrial fibrillation and heart failure, research has found a lower risk of death with ablation plus recommended medicines than with medicines alone. Your electrophysiologist can tell you whether this applies to you.
Source: 7
It takes time. Irregular beats are common during the healing (blanking) period, which lasts about 2 months after pulsed field ablation (PFA) and 3 months after radiofrequency ablation. Whether the ablation has worked usually becomes clear after that. Your follow-up at 3 months, including a 14-day heart monitor, helps answer this question.
If symptoms continue or come back after that, a repeat procedure or a different treatment may be considered.
Sources: 2, 3
Most of the short circuits that cause atrial fibrillation are found around the four pulmonary veins, which bring blood from the lungs back into the left upper chamber of the heart. The ablation is done in a ring around these veins to electrically isolate them. This is why an atrial fibrillation ablation is also called a pulmonary vein isolation. Other areas with abnormal signals may also be treated.
Source: 6
Sources: 6, 3
The overall risk of a complication is less than 1%.
Common and minor: some bruising or swelling at the insertion site, and chest discomfort that settles within 1 to 3 days.
Rare:
Extremely rare:
Some of these risks, such as phrenic nerve injury, narrowing of the pulmonary veins and esophageal injury, are linked mainly to ablation methods that use heat or cold.
Sources: 6, 1, 7
Once you and your electrophysiologist or Heart Rhythm nurse practitioner decide on an ablation, the Heart Rhythm coordinator will put you on the wait list. Closer to your procedure date, the coordinator will arrange any tests you need, which may include:
Source: 6
Yes. You need to be on a blood thinner for at least 1 month before your ablation. Do not stop it on your own. The blood thinner is often continued through the procedure or paused only briefly. If any of your blood thinner, rhythm or heart rate medicines need to be held, you will be told once your procedure is booked.
Sources: 6, 3, 7
For at least 3 months. After that, whether you continue depends on your personal risk of stroke, not on whether the ablation worked. Some people also take a rhythm medicine for a short time to reduce early episodes. Do not stop any of these medicines unless your team tells you to.
Sources: 3, 7
Sources: 6, 9
Short episodes that stop on their own are common in the first few months. You do not need to go to the Emergency Department unless you feel faint or have severe symptoms.
If atrial fibrillation lasts longer than 24 hours, seek medical attention. A cardioversion (a controlled reset of the heart rhythm) may be needed, which can be arranged through the Emergency Department.
Do not wait 24 hours if your heart rate is fast (over 150 beats per minute) and uncomfortable for more than 3 hours. Go to the Emergency Department or call 911.
Sources: 6, 3
You may be. Referral to cardiac rehabilitation is not automatic: your team will refer you if you meet the program's criteria. If you are referred, the cardiac rehabilitation clinic closest to you will usually call you about 1 month after your ablation.
Exercise programs reduce the chance of atrial fibrillation coming back and improve the success of the ablation. If you are interested in cardiac rehabilitation, ask your team whether you qualify.
Sources: 3, 6
Lifestyle changes will not cure atrial fibrillation, but they reduce symptoms and improve the long-term success of your ablation. Start before your procedure and keep going afterward, especially in the first 3 months.
No specific diet, vitamin, herbal product or supplement (such as fish oil) has been shown to reduce atrial fibrillation.
Source: 6
Pulsed field ablation (PFA) uses very short bursts of high-energy electrical pulses instead of heat or cold. The pulses disrupt the walls of the targeted heart muscle cells. PFA targets heart muscle closely, with little effect on nearby tissue such as nerves or the esophagus (food pipe). This makes it a very safe way to ablate.
PFA is mainly used for pulmonary vein isolation in atrial fibrillation ablation. For atrial fibrillation, studies have found broadly similar rhythm results with PFA, radiofrequency and cryoablation.
Sources: 5, 6, 7
Yes. After PFA, drink 6 to 8 glasses of water on the day of your procedure and the day after. If you have heart failure or have been told to limit your fluids, check with your team first.
PFA can break down a small number of red blood cells, and drinking extra water helps protect your kidneys while your body clears them. This is not usually needed after radiofrequency ablation.
Call us the same day if, in the first 1 to 2 days after PFA, your urine turns dark, tea-coloured or cola-coloured, or you are passing very little urine.
Sources: 3, 6
With pulsed field ablation, the energy can cause the muscles to twitch, which can be uncomfortable. It can also cause coughing, which may shift the three-dimensional (3D) map of your heart that guides the procedure. A general anaesthetic keeps you comfortable and still, so the procedure can be done accurately.
Source: 3
If you can come in on short notice, sign up to be called when an earlier spot opens.
Sign-up link and QR code coming soon.
Tanja, our ablation coordinator, will call you to book your procedure. Closer to your date, the coordinator's office will also arrange any tests you need beforehand.
Wait times change over time. Please make sure we have your current phone number, and return our calls as soon as you can.
Sources: 3, 6
Possibly. We keep a cancellation list, and when a spot opens up, the coordinator may call you with shorter notice. If you are able to come in on short notice, sign up for the cancellation list using the link or QR code at the top of this section.
Source: 3
Call the coordinator's office as soon as possible if you become unwell before your procedure, for example with a fever, cough, cold, flu or infection. We may need to rebook your procedure.
Letting us know early gives us time to offer your spot to another patient who is waiting.
Source: 3
Call the coordinator's office as early as you can. The more notice we have, the more likely we can give your spot to someone else on the wait list.
Source: 3
Usually you will stop eating and drinking for several hours before, often from midnight the night before. You will be given exact instructions before your procedure.
Sources: 2, 5
Heart rhythm medications vary a lot from person to person. You may be asked to hold some medicines before your procedure, or you may be prescribed a temporary new medicine. These instructions are given to you once your procedure is booked.
If you take a blood thinner such as apixaban, rivaroxaban, edoxaban, dabigatran or warfarin, do not stop it on your own. Follow your team's instructions.
Unless you are told otherwise, take your other medicines as usual on the morning of your procedure, with a sip of water.
Some diabetes and weight loss medicines must be stopped days ahead. See "Which medicines do I need to hold before my procedure?" below.
Sources: 2, 3, 5, 6
Your pre-procedure handout lists every medicine to hold and when. Two groups of medicines need to be stopped well ahead of a general anaesthetic:
| SGLT2 inhibitors (used for diabetes, heart failure or kidney disease) Empagliflozin (Jardiance), dapagliflozin (Forxiga), canagliflozin (Invokana), and combination pills such as Synjardy and Xigduo | Stop 3 days before your procedure |
| GLP-1 medicines (used for diabetes or weight loss) Semaglutide (Ozempic, Wegovy, Rybelsus), tirzepatide (Mounjaro), liraglutide (Victoza, Saxenda), dulaglutide (Trulicity) | Stop at least 1 week before your procedure, and preferably 3 weeks before. Your team will confirm the exact timing. |
SGLT2 inhibitors can rarely cause a dangerous build-up of acid in the blood around the time of fasting and anaesthesia. GLP-1 medicines slow down how quickly your stomach empties, so food can still be in your stomach during anaesthesia.
If you take any of these for diabetes, ask your family doctor or diabetes team how to manage your blood sugar while they are on hold. Do not stop your blood thinner unless your team tells you to.
Source: 3
Tell us right away. Call the coordinator's office as soon as you realize you have missed a dose in the weeks before your procedure.
Missed doses can raise the chance of a blood clot forming in the heart. Depending on how many doses were missed and when, your procedure may need to be delayed and rescheduled. Or, on the day of your procedure, your team may need to check your heart for a blood clot first, using either:
Both of these are invasive tests. Do not take extra doses to make up for a missed one unless your team tells you to.
Source: 3
Yes. Seasonal vaccines, such as the flu and COVID-19 vaccines, are recommended for people with heart conditions, and having an ablation is not a reason to skip them.
Source: 3
Yes. You will not be able to drive yourself home, so arrange for someone to pick you up. A responsible adult should also stay with you overnight after you go home.
If you need to stay in hospital overnight, have a ride ready for an early morning discharge.
Sources: 2, 6
Several local hotels offer a compassionate rate for patients and families. You book and pay for your stay yourself, and rates vary by hotel.
Drive times are to the hospital at 911 Queen’s Blvd., Kitchener, listed from closest to farthest.
Source: 17
Please bring:
Wear comfortable clothing. All jewellery must be removed for the procedure, so please leave it and other valuables at home. Please remove nail polish and makeup, and do not wear perfume or scented lotion.
You will also receive a pre-procedure handout listing what to bring and which medicines to hold.
Pre-procedure handout: link coming soon.
Sources: 3, 5, 6, 11
Improving your overall health gives you the best chance of a good long-term result:
If you are having an atrial fibrillation ablation, see the atrial fibrillation section for more specific advice.
Sources: 2 (citing the Irish Heart Foundation), 3
It depends on the rhythm being treated. Typical times are:
| Atrial fibrillation ablation | About 1 hour |
| Atrial flutter ablation | About 1 hour |
| Diagnostic electrophysiology (EP) study | About 1 hour |
| Supraventricular tachycardia (SVT) ablation | About 2 hours |
| Premature ventricular contraction (PVC) ablation | About 3 hours |
| Ventricular tachycardia (VT) ablation | About 3 hours |
This is the time in the procedure room. Preparation and recovery take longer, so plan to be at the hospital for most of the day.
Sources: 3, 1, 6
Sources: 5, 3
It depends on your procedure.
Sources: 3, 6, 16, 1
If you are having a general anaesthetic, you will be asleep for the whole procedure.
If you are having sedation, you may feel a brief sting when the intravenous (IV) tubes are placed in the leg veins. To reduce this, numbing cream is put on the skin first, and then local freezing is injected into the skin and the tissue underneath. You will also get comfort and relaxation medicine through your IV at the start, and more as needed. The rest of the study is usually painless.
Sources: 3, 1
About 2 hours, on average. This lets the puncture sites in your groin seal. The exact time depends on how you recover. Your nurse will check your groin often for bleeding or swelling, and will tell you when it is safe to sit up and start moving.
Sources: 3, 6
Yes, for most people. Going home the same day is our standard of care. Between registration, preparation, the procedure and recovery, plan to spend most of the day at the hospital.
An overnight stay may be needed if you have other significant medical conditions, if your procedure was more complicated, or if you are having a ventricular tachycardia (VT) ablation.
Sources: 3, 1, 6
Your doctor and nurse will go over your procedure with you. You will also receive a letter explaining your ablation, with instructions about your heart rhythm and blood thinner medicines, and a "What to Do When You Go Home" brochure covering care of your puncture sites and when to call the clinic or go to the Emergency Department.
Source: 6
Sources: 3, 10, 12
Sources: 2, 3, 7, 9, 10
Sources: 2, 3, 5, 6, 9, 10
If you notice new or unusual symptoms, or if tiredness or other symptoms are severe, getting worse, or lasting longer than expected. Symptoms after ablation are not always an emergency; sometimes they simply mean your medications need adjusting.
Short episodes of atrial fibrillation that stop on their own do not need a trip to the Emergency Department, unless you feel faint or have severe symptoms. If atrial fibrillation comes back but you are otherwise feeling well and taking your blood thinner, it is not an emergency: call our office during regular business hours.
Sources: 2, 6, 7, 9
Sources: 2, 3, 6, 9, 10, 12, 13
| First night | A responsible adult stays with you |
| After 1 to 2 days | Usually fine to fly, depending on your procedure |
| First 48 hours | No driving |
| 2 to 7 days | Most people are back to normal daily activities |
| First week | No heavy lifting, strenuous exercise or sex; no baths or swimming |
| About 1 month | Call from cardiac rehabilitation, if you have been referred |
| 2 to 3 months | Healing (blanking) period: irregular beats are common. About 2 months after pulsed field ablation (PFA), 3 months after radiofrequency ablation. |
| 3 months | Follow-up: 14-day heart monitor and a call from our nursing team |
| 1 year | Follow-up |
Sources: 2, 3, 4, 6, 8
Not necessarily. It is normal to have palpitations, extra beats, or episodes of an abnormal rhythm while the heart heals: about the first 2 months after pulsed field ablation (PFA), or the first 3 months after radiofrequency ablation. This is called the blanking period. The heart tissue needs time to heal, and the rhythm often settles as it does.
Seek medical attention if palpitations are getting more severe, or if atrial fibrillation lasts longer than 24 hours. Go to the Emergency Department or call 911 if your heart rate is over 150 beats per minute and uncomfortable for more than 3 hours, or if palpitations come with shortness of breath, feeling faint, passing out, or chest pain.
Sources: 2, 3, 5, 6
Yes. Bruising where the catheters went in is common, and it can spread down the leg, sometimes past the knee, especially if you take a blood thinner. Some people also get a small lump (a hematoma) at the site. A lump smaller than a quarter is normal. Bruising, swelling and any small lump should go away over 3 to 4 weeks.
For soreness or swelling, you can put ice or a cold pack on the area for 10 to 20 minutes at a time, with a thin cloth between the ice and your skin.
Get medical attention if the lump is larger than a quarter, keeps getting bigger, becomes very red, or is more painful or throbbing, or if the site bleeds heavily. If it bleeds, follow the first aid steps at the top of this page.
Sources: 2, 9, 10
Mild tenderness and bruising near the puncture site are common in the first few days. After atrial fibrillation ablation, mild swelling of both hands, feet or legs can also happen from intravenous (IV) fluids, and should go away over 3 to 4 days.
Get medical attention the same day if one whole leg becomes swollen, or if numbness, pain or tingling in the leg does not go away. Call 911 if your leg turns cold or pale, or you lose feeling in it.
Sources: 3, 6
Some people have temporary chest discomfort as the heart heals. This usually settles within 1 to 3 days.
A sharp chest pain that is worse when you lie down, breathe in deeply or cough, and better when you sit up and lean forward, can be a sign of irritation of the sac around the heart (pericarditis). This usually eases over a few days, and some people need an anti-inflammatory medicine, which your team will prescribe if needed. Call us the same day if this happens.
If a burning chest pain lasts more than 3 days, call our office.
Chest pain together with palpitations, shortness of breath or feeling faint needs emergency care.
Sources: 2, 3, 6
Drowsiness is expected until the anaesthetic or sedation wears off. After sedation this takes a few hours. After a general anaesthetic it can take up to 48 hours, and you may also have nausea, a sore throat or a cough for a few days.
For the first 24 hours, do not make important decisions, sign legal documents, or do anything that needs close attention, as the medicine takes time to wear off completely.
Sources: 2, 6, 10
Most people have no pain. If the puncture site is sore, simple pain relievers can help. Soreness usually lasts a week at most.
Acetaminophen (Tylenol) is the preferred pain reliever while you are on a blood thinner. Avoid ibuprofen (Advil, Motrin), naproxen (Aleve) and other anti-inflammatory medicines unless your team tells you to take one, as they raise the risk of bleeding.
Sources: 2, 3
Some people get migraine-type headaches in the days or weeks after an atrial fibrillation ablation, even if they have never had migraines before. A migraine can come with an "aura": flashing lights, zigzag lines or a shimmering blind spot that slowly spreads, usually lasts 5 to 60 minutes, and then goes away completely. These headaches usually settle on their own over time.
Call our office if headaches keep coming back, or if visual changes do not go away completely within 1 hour.
Call 911 if a headache is sudden and severe, or comes with weakness, numbness, drooping of the face, trouble speaking, confusion, loss of vision or double vision. These can be signs of a stroke.
Source: 3
Yes, hiccups can happen after an ablation, especially after an atrial fibrillation ablation under general anaesthetic. They usually settle on their own within a day or two.
Call our office if hiccups last longer than 48 hours or stop you from eating or sleeping. Get medical attention the same day if hiccups come with pain or trouble swallowing, chest pain, shortness of breath or vomiting.
Source: 3
During your procedure, the anaesthesia team may give you a medicine called glycopyrrolate. It helps keep your airway dry and your heart rate steady, but for a short time afterward it can make it harder to empty your bladder. This is called urinary retention. It is more common in men with an enlarged prostate and in people who have had trouble passing urine before.
Before your procedure: tell your team if you have prostate problems or have had trouble passing urine in the past.
Signs to watch for: you feel the urge to go but little or no urine comes out, your stream is weak, or your lower belly feels full, swollen or painful.
Things that can help:
Go to the nearest Emergency Department if you cannot pass urine within 8 hours of going home, or sooner if your lower belly becomes painful and swollen. A small tube (catheter) may be needed to empty your bladder for a short time.
This is different from the dark or reduced urine that can rarely follow pulsed field ablation (PFA). With urinary retention you feel the need to go but cannot; see the PFA section for the other.
Source: 3
Sources: 2, 9, 10
Rest for the first few days. For 1 week, avoid strenuous exercise and lifting anything heavier than 10 pounds (about 4.5 kg). When you feel ready, build your activity up gradually. Most people can manage brisk walks by the second week.
Sources: 3, 2, 5
Wait 1 week after your procedure before having sex. This gives your groin time to heal and follows the same 1-week limit as other strenuous activity and heavy lifting.
After that, if you are feeling well, you can return to your usual activity. Stop and follow "When to get medical help" at the top of this page if you have bleeding or swelling at the puncture site, chest pain, shortness of breath or palpitations.
Sources: 11, 3
You can usually drive again 48 hours after your procedure, as long as no new rhythm problems have come up. This follows the Canadian Cardiovascular Society fitness to drive guidelines.
Wait longer if you still feel drowsy from the anaesthetic, or if the puncture site is painful. Your team will tell you if a longer restriction applies to you, for example after some ventricular tachycardia (VT) ablations.
Sources: 4, 6, 2
If you are feeling well and your rhythm is stable, you can usually fly:
| Ablation for an upper chamber rhythm (atrial fibrillation, atrial flutter, supraventricular tachycardia (SVT)) | 1 day after your procedure |
| Ablation for a lower chamber rhythm (ventricular tachycardia (VT), premature ventricular contractions (PVCs)) | 2 days after your procedure |
This follows the Canadian Cardiovascular Society fitness to fly recommendations. Remember you cannot drive for 48 hours, so plan your trip to the airport accordingly.
For long flights or drives in the first 2 days, get up and walk or stretch for about 10 minutes every hour.
Planning a longer trip? See the next two questions.
Sources: 8, 4, 12
Sources: 3, 6, 12
It might. Most travel insurance policies have a pre-existing condition clause. Your heart rhythm problem counts as a pre-existing condition, and to be covered for it, the condition usually has to be "stable" for a set time before you leave.
What to do: call your insurer or broker before you book a trip, and if possible before your procedure. Plan to travel at least 3 months after your ablation and your last medicine change, or longer if your policy requires it. Always declare your heart condition honestly: leaving it out can lead to a claim being denied or the policy being cancelled.
Sources: 3, 14, 15
It depends on your job and your procedure. Most people are back to normal activities within 2 to 7 days.
Recover at your own pace. Your team will advise you on your own timeline.
Sources: 2, 3, 5, 6
Yes, you can eat and drink normally after your procedure. If your stomach is upset, try bland, low-fat foods such as plain rice, chicken, toast and yogurt. Avoid alcohol for at least 24 hours.
Sources: 2, 10
Yes. Keep taking the medicines you have been prescribed, including any blood thinner, unless your team tells you otherwise. After an atrial fibrillation ablation, blood thinners continue for at least 3 months. Your team will tell you when heart rhythm and heart rate medicines can be stopped; see the next question.
If you had radiofrequency ablation, you will also be asked to take stomach protecting medicines; see the next section.
Sources: 2, 3, 5, 6
Often, yes. When they are stopped depends on the rhythm that was treated:
| Atrial fibrillation | Both rhythm medicines and heart rate medicines taken only for atrial fibrillation are usually stopped 1 month after pulsed field ablation (PFA), or 2 months after radiofrequency ablation. |
| Supraventricular tachycardia (SVT) | Rhythm and heart rate medicines taken for SVT are usually stopped when you are discharged after your ablation. |
| Premature ventricular contractions (PVCs) or ventricular tachycardia (VT) | These medicines may be continued. Your electrophysiologist will decide. |
Examples of rhythm medicines (antiarrhythmics): flecainide, propafenone, sotalol, amiodarone, dronedarone (Multaq).
Examples of heart rate medicines (AV nodal blockers): metoprolol, bisoprolol, atenolol, diltiazem, verapamil, digoxin.
If one of these medicines also treats another condition, such as high blood pressure, heart failure or angina, it may be continued for that reason. Blood thinners follow a separate plan (at least 3 months after atrial fibrillation ablation). Do not stop any medicine on your own: your plan will be in your discharge letter or given to you at follow-up.
Sources: 3, 6
Radiofrequency ablation uses heat energy. If you are not sure which type of ablation you had, ask your team.
Video: Preparing for your radiofrequency ablation
Dr. Umjeet Jolly, electrophysiologist with our program, explains what to expect.
The esophagus (food pipe) sits right behind the left upper chamber of the heart. After radiofrequency ablation, we recommend two medicines to protect it while it heals:
Take both for 6 weeks after your ablation, exactly as prescribed. Your own prescription may differ, so always follow the instructions on your medicine labels.
Take sucralfate at least 2 hours apart from your other medicines. It can stop other medicines, including some heart rhythm medicines, from being absorbed properly.
Sources: 3, 6, 9
Very rarely, about 1 in 1,000 cases, the heat used during atrial fibrillation ablation can injure the esophagus. During radiofrequency ablation, a small temperature probe may be placed in your esophagus to help protect it. This probe is not used for pulsed field ablation (PFA). If an injury happens, symptoms usually show up 2 to 3 weeks after the procedure, often after you already feel recovered.
Get medical attention the same day if you have pain or trouble when swallowing.
Call 911 or go to the Emergency Department if you have fever with chest pain, vomiting blood, black stools, or any signs of a stroke. Tell them you recently had an ablation.
Sources: 6, 3
Pericarditis is irritation of the thin sac around the heart. It can cause a sharp chest pain that is worse when you lie down, take a deep breath or cough, and often better when you sit up and lean forward.
Call our office the same day if you have this kind of pain. If chest pain comes with shortness of breath, feeling faint or palpitations, call 911.
Sources: 3, 6
At about 3 months:
At 1 year: a further follow-up.
Irregular rhythms can come back soon after ablation or later, sometimes without any symptoms, which is why your heart rhythm is monitored. At follow-up, your team will talk with you about your medicines and whether any further treatment is needed. You do not need to wait for these appointments if you have concerns. Call our office any time you have new or worsening symptoms.
Sources: 3, 6, 7
Antiarrhythmic: A rhythm medicine that helps keep the heart in a normal rhythm, such as flecainide, sotalol or amiodarone.
Anticoagulant: A blood thinner, such as apixaban (Eliquis), rivaroxaban (Xarelto), edoxaban (Lixiana), dabigatran (Pradaxa) or warfarin. Lowers the risk of stroke.
Atrial fibrillation (AF, AFib): An irregular, often fast rhythm in the upper chambers of the heart.
Atrial flutter: A fast, regular rhythm in the upper chambers of the heart.
AV node, AV nodal blocker: The AV (atrioventricular) node passes signals from the upper to the lower chambers. AV nodal blockers are heart rate medicines, such as metoprolol, diltiazem or digoxin.
Blanking period: The healing time after an ablation when irregular beats are common: about 2 months after PFA and 3 months after radiofrequency ablation.
Cardioversion: A controlled reset of the heart rhythm, usually with a brief shock while you are asleep.
Catheter: A thin, flexible tube passed through a blood vessel to the heart.
CCS: Canadian Cardiovascular Society.
Conscious sedation: Medicine through your IV that makes you relaxed and drowsy, without a breathing tube.
Cryoablation: Ablation that uses cold.
CT: Computed tomography: a detailed scan that shows the shape of your heart.
ED: Emergency Department.
EP: Electrophysiology: the study of the heart's electrical system. An electrophysiologist is a heart rhythm specialist doctor.
Esophagus: The food pipe, which sits right behind the heart.
General anaesthetic: Medicine that puts you fully asleep, with a breathing tube.
GLP-1 medicine: Glucagon-like peptide 1 medicine for diabetes or weight loss, such as semaglutide (Ozempic). Must be held before anaesthesia.
Glycopyrrolate: A medicine sometimes given during anaesthesia that can briefly make it harder to pass urine.
Hematoma: A collection of blood under the skin, felt as a lump.
Holter monitor: A small recorder you wear to track your heart rhythm, for 14 days after your ablation.
ICE: Intracardiac echocardiography: an ultrasound catheter placed inside the heart.
IV: Intravenous: a small tube placed in a vein to give fluids and medicines.
NP: Nurse practitioner.
Palpitations: Feeling your heart racing, pounding, fluttering or skipping.
Pericarditis: Irritation of the thin sac around the heart, causing sharp chest pain.
PFA: Pulsed field ablation: ablation that uses very short bursts of electrical energy instead of heat or cold.
Phrenic nerve: The nerve that controls the diaphragm, your main breathing muscle.
PPI: Proton pump inhibitor: a medicine that lowers stomach acid, such as pantoprazole.
PVC: Premature ventricular contraction: an extra beat from the lower chambers of the heart.
PVI: Pulmonary vein isolation: the main ablation for atrial fibrillation.
RF, RFA: Radiofrequency ablation: ablation that uses heat.
SGLT2 inhibitor: Sodium-glucose cotransporter 2 inhibitor, used for diabetes, heart failure or kidney disease, such as empagliflozin (Jardiance). Must be held before anaesthesia.
Sheath: A short tube placed in a blood vessel so catheters can pass through.
SVT: Supraventricular tachycardia: a fast heartbeat starting in the upper part of the heart.
TEE: Transesophageal echocardiogram: an ultrasound probe passed down the throat to look for blood clots in the heart.
Transseptal puncture: A small opening made in the wall between the upper chambers so a catheter can reach the left side.
VT: Ventricular tachycardia: a fast heartbeat starting in the lower chambers of the heart.
WPW: Wolff Parkinson White syndrome: an extra electrical pathway in the heart.
WRHN: Waterloo Regional Health Network.
3D mapping: Three-dimensional mapping: a computer model of your heart used to guide the procedure.
mg, g, kg: Milligrams, grams and kilograms.
Sources: 6, 3
Waterloo Regional Health Network, Arrhythmia Clinic
WRHN @ Queen's Blvd., First floor, 911 Queen's Blvd., Kitchener, Ontario N2M 1B2
Phone: 519-749-6578, extension 1500
Online: on wrhn.ca, go to Healthcare Services, then Cardiac Outpatient Clinics, then Arrhythmia Clinic. Or go straight to the Cardiac Outpatient Clinics page.
Email, office hours and after-hours instructions to be added.
For health advice from a registered nurse at any time, call Health811 by dialling 811. For an emergency, call 911.