After Your (PVAI) Procedure
We wish you a speedy recovery from your Pulmonary vein isolation ablation (PVAI) . Here is some important information for when you return home.
Some Discomfort
You may feel discomfort at the catheter insertion during the first 24 hours after the procedure. The doctor will tell you what medications you can take for pain relief. You may also experience mild chest discomfort, mild shortness of breath and fatigue after the procedure.
Heart Rhythm
Extra heartbeats, a racing heart, atrial fibrillation or skipped heartbeats commonly occur on and off for the first 8 weeks after the procedure. When these symptoms occur during your recovery, you will be instructed to record your symptoms using a telephone transmitter (home monitor). You will also be instructed to call the Arrhythmia Monitoring Lab.
These symptoms are all normal and should subside within 5 to 7 days after the procedure. However, please call your healthcare provider if your symptoms are prolonged or severe.
Rarely, atrial fibrillation may be worse for a few weeks after the procedure and may be related to inflammation where the lesions were created.
Telephone transmitter
You will receive a telephone transmitter for home. Transmit weekly and if you feel like you have gone into atrial fibrillation. The nurse will call if the rhythm requires urgent care or if you are experiencing symptoms.
Medications
For at least 3 months after the procedure, you will need to take an anticoagulant medication to prevent blood clots and reduce the risk of stroke. You may need to continue this medication for longer than 3 months, depending on your individual risk for stroke. If you are on warfarin(Coumadin), you must have frequent blood tests (called INR/Protime) to evaluate your dosage. Your INR should be between 2.0 and 3.0. Your doctor will tell you how often to have this test. Please schedule these blood tests with your local doctor’s office.
You may also need to take an antiarrhythmic medication to control abnormal heart beats for 2 months after the procedure.
Ask your doctor if you should keep taking the medications you took before you had the procedure.
You will receive the necessary prescriptions and medication instructions from your doctor.
Care for the procedure site
You may take a shower. However, avoid water temperature extremes. Do not take a bath, swim or soak in water for 7 to 10 days after the procedure or until the incision sites have healed.
Keep the procedure site clean and dry. Do not scrub the area. You do not need to keep the area covered with a bandage. Do not use creams, lotions or ointments on the procedure site.
Look at the area daily to make sure it is healing properly. If you notice any of the signs of infection, please call your doctor.
Activity
These activity guidelines should be followed the first week after your procedure:
- Do not lift anything that weigh more than 10 pounds.
- Avoid activities that require pushing or pulling heavy objects, such as shoveling the snow or mowing the lawn.
- Stop any activity before you become overtired.
- You may resume your normal exercise and activity routine 1 week after the procedure.
- Your doctor will tell you when you can resume driving, go back to work, usually within a week after you go home. If you have the flexibility at your job, ease back to your regular work schedule.
Follow-Up Appointments
Follow Up with Local Physician
Please schedule a follow-up visit with your local physician within 1 week after the procedure to discuss your Coumadin and to have your INR level tested.
Please continue to take your Coumadin as directed until you are given other instructions at your follow-up visit.
Follow-Up Appointment at Cleveland Clinic
A Cleveland Clinic follow-up appointment will be scheduled 3 to 4 months after your procedure. You will receive a reminder card for this appointment. However, if you don’t receive an appointment notice within 3 weeks after your procedure, please call 216.444.6697 or 800.223.2273, ext. 46697 to schedule this appointment.
Based on your medical history, you may need to have a creatinine blood test before the CT scan. This test can be completed at the same time as your INR blood test. Your nurse will tell you if you need this test. This test will need to be completed no more than 60 days after you follow-up appointment.
If you are still experiencing atrial fibrillation at the time of your follow-up visit, you may need a repeat ablation.
Please bring your telephone transmitter to your Cleveland Clinic follow-up appointment.
These tests may be performed at your follow-up appointment:
- Spiral computed tomography (CT) scan* to evaluate the presence of pulmonary vein narrowing: You will need to fast (not eat or drink anything) for 6 hours before this appointment.
- 2-D echocardiogram (Echo) or transesophageal echocardiogram (TEE).
- Electrocardiogram (EKG).
- Other blood tests/lab work.
*The CT scan involves the use of an intravenous contrast material. If you are allergic to contrast material, dye or shellfish, please notify us immediately so you can receive a medication to take before the test. You will need to come to Cleveland Clinic for a follow up appointment about 3 months after the procedure. This appointment is usually scheduled before you go home.
When to Call
If you have any questions, call your physician’s office and ask to speak to the Afib nurse.
Please call right away if you have any of the symptoms listed below.
- Lump develops at the catheter insertion site or increases in size
- Abnormally low blood pressure (systolic reading less than 90 mm/Hg)
- Worsening of symptoms
- Mild shortness of breath, fatigue or chest discomfort that lasts longer than 5 days
- Signs of infection at the wound site:
- Increased drainage, bleeding or oozing from the insertion site
- Increased opening of the incision where the device was implanted
- Redness, swelling or warmth around the device insertion site
- Increased body temperature (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius)
For any questions or concerns, you can call the phone number on your magnet or discharge instructions to speak with a registered nurse. After hours, you can contact the hospital operator to speak to the EP-Fellow On-Call.
