Pulmonary Vein Isolation (PVI)

Pulmonary Vein Isolation is a form of cardiac ablation; it is used to treat atrial fibrillation. It works by scarring or destroying heart tissue that triggers an abnormal heart rhythm. The procedure is done under general anesthesia by an anesthesiologist. General anesthesia uses medications to put you into a deep sleep and a breathing tube. This breathing tube will be removed at the end of the procedure.

Prior to the procedure:

• Patients will typically be told not to eat or drink after midnight; however your doctor will give you specific instructions to follow.

• Your chest, back and groin will be shaved.

• Anesthesia will see you and may place an arterial line to monitor blood pressure throughout the procedure.

During the procedure:

• The EP lab is cool, so you will be given warm blankets.

• You will be closely monitored by several patches that will be placed on your chest, back, arms, and legs.

• A sterile sheet will be draped over you from your neck to your feet. This will be done once you are asleep and the breathing tube is in place.

• One to four catheters will be placed in your femoral (groin) vein. The doctor will then move the catheters to your heart.

• Once the catheters are in place the doctor will locate the abnormal pathway and begin ablating.

• The procedure could take one to four hours.

Post procedure:

• The catheters in your groin will be removed, and pressure will be held for 10 to 20 minutes, possibly longer. The doctor will place a suture and dressing. This will be removed by the nurse in 2-4 hours.

• The breathing tube will be removed, and you will recover in PACU. (Post Anesthesia Care Unit)

• You will be on bed rest for a number of hours determined by your doctor.

• It will be up to your doctor if you need to stay the night.

Home Guidelines

• Recovery time varies depending on your response to anesthesia. You may feel tired, low on energy and have decreased stamina for several days.

• Recurrent atrial fibrillation episodes are not uncommon during the first 3 months post PVI. Call your provider if the episode lasts greater than one to two hours.

• Monitor your groin site for any firmness. Firmness, larger than pea size, at the groin site could be a sign of bleeding under the skin. If this occurs and you are alone, apply pressure with your fist to the groin site, then bend at the waist to increase the pressure. If someone is with you, have them place his/her fist on the insertion site.

• Bruising at the groin site is common, however the site should be soft and without severe pain.

• Dressing can be removed after 24 hours.

• Clean groin site daily with soap and water until healed.

• Leave groin site open to air. If clothing rubs you may cover with a band aid.

• No strenuous work for 1 week.

• Do not lift more than 10 pounds for 1 week.

• If traveling for a long distance, get up and walk several steps every one to two hours.

• You may shower. No soaking in a bathtub until incision site is healed.

• You may return to your usual sexual activity in one to three days.

• Ask your doctor when you may return to work.

• Climb stairs as little as possible for three to five days.

Call your doctor for any of the following symptoms:

• Bleeding at the incision site

• Signs of infection at the groin site redness swelling, increased pain, drainage, or fever

• The leg in which the catheters were inserted feels cold or numb

• Shortness of breath, chest, neck or arm pain

• Increased pain or nausea

• Black or tarry stools or blood in urine

• Fainting or near black outs

• Swelling in legs or feet or decreased urine output