ablation

Vascular Access for Catheter Ablation

by Gemita - 2022-06-12 14:28:54

Hello new to pace.  Hope all well your end.  

The catheter for an ablation can be inserted in the groin (femoral vein), shoulder (subclavian vein) or neck (less commonly) via the jugular vein.    Have a look at the Catheter insertion points for cardiac ablation in the attached first link (you will need to scroll down a bit).  I suppose it will depend on the health of our blood vessels.  They will obviously want to choose the best site to gain access.  

For further reading, see also the second link where catheter ablation can also be safely carried out via vascular access from the arms.

For my EP study they used the femoral vein (right).  I developed a pseudo aneurysm and was hospitalised for several days and taken off anticoagulants.  Not a nice experience.  I was in AF at the time of my EP Study but hadn't consented to an ablation, only to the Study. In hindsight it would have been a perfect opportunity to have had one carried out while in AF since my EP clearly saw from where my AF originated.  Never mind I am still doing well.

https://www.mayoclinic.org/tests-procedures/cardiac-ablation/about/pac-20384993#dialogId28974201

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226276/

Ablation Catheter Access

by Marybird - 2022-06-12 15:03:31

My daughter has had a number of ablations done over the years, and if I recall with some of those they used the jugular vein for access, in addition to the femoral vein.

ablation

by new to pace.... - 2022-06-12 15:23:25

Thanks Gemita and Marybird  for your thoughtful answers.  I asked as before only heard of going through femoral  vein.  As we know i am thought to be to old for an ablation.

new to pace

ablation

by AgentX86 - 2022-06-12 18:29:09

All of my ablations were through the vemoral vein.  Access via the carotid would have freaked me out.  ;-)  I had an angiogram via the radial artery.  If you need a heart cath, that's the place.  It's easy and you're in and out.  There is no need to lay flat for hours.  They can put a pressure bandage directly on it because they have the wrist to wrap it around.  A tourniquet around the leg wouldn't be good. After a few hours, just take it off.

Ablation Cath Sites

by Marybird - 2022-06-12 18:55:59

If I remember correctly, I think that depending on the ablation, they may use several catheters at a time and may consider the jugular vein as a possible access. I'd imagine trying to shove several catheters up one femoral vein might get things a bit crowded, so perhaps that is why the additional access through the jugular.

My daughter had a total of 7-8 ablations ( including one a-fib ablation) from about 2009 through 2016 (her last one, she will have no more) and some of those were very involved, took around 8 hours. I think there were perhaps 2-3 of them that involved the use of the jugular vein, in addition to the femoral. Her last ablation ( before the touchup in 2016) involved an epicardial approach through a thoracotomy incision, as the site of the tachycardia was too close to the phrenic nerve with an intracardial approach. It was successful, though. Poor thing, she is glad those days are over.

New To Pace, not sure if you'd really be considered too old for an ablation, though, if it was indicated. I have a friend who is about 82 yrs now, and she recently had an ablation for both A-Fib and A-flutter- at the same time. But she was almost constantly in either A-fib or flutter, and was in serious heart failure and going downhill, and not responding well to medications to try and control it. So I think they considered the risk vs benefits for her ablation, and she hasn't had any problems since the ablation. She had an EP in Sarasota do her ablation. He does a lot of them, and is excellent, from what I hear.

That said, I'm not on the ablation boat either. But I'm doing well with the medications.

ablation

by new to pace.... - 2022-06-12 20:15:33

marybird if you would PM me with the name of her EP. thanks

new to pace

ablation

by new to pace.... - 2022-06-13 09:41:34

want to correct one of my previous comments.  Her abalation was not done at a major hospital. but our local public hosiptal Sarasota Memorial.  By a new EP in the same office where i go.

new to pace

Ablatation Catheter sites

by Secrent - 2022-06-13 15:50:28

I recently had an ablation, and they went up both sides of my groin for the Catheters.  Everything went well, I took it easy for a week, then found the incision for the catheter on the right side had opened up.  They glue the incision together after the ablation.  Well, what I had after it opened up was a wound or "hole" about the size of a nickle that just would not heal.  Went to my physician as the office of my Cardiac electrophysiologist who did the ablation just said to watch it and it will heal up.  My physician swabbed it for culture and prescribed anitbiotics and said it needs to heal from the inside out and to watch it, if it didn't get better he would send me to a wound center.  Culture came back with Light growth Streptococcus anginosus group.  The antibiotics are working and the wound is showing signs of healing up slowly.  Such a bad area for an open wound, right in the crease of your groin.  Lucky I went when I did to my pyhsician, otherwise the infection would have gotten worse.

ablation wound

by new to pace.... - 2022-06-13 16:29:02

Sorry Secrent that you had such a problem.  You were smart to have your GP take a look. 

Thinking now some EP cannot see beyond.  when i had the pacemaker implanted they used surgical glue to close.  When i went back for follow up mentioned that I had raised bumps that itched.  Was told they would go away.  Yes they went away as soon as i could get the glue off.  Now am allergic to the glue.  

new to pace