The Cryoablation Procedure Information about atrial fibrillation for patients and their family members • How the cryoablation procedure helps to control atrial fibrillation • Benefits a cryoablation procedure may offer • What to expect during the cryoablation experience at Valley View • What to expect after your treatment 1 Valley View’s Table of contents Heart & Vascular team The Cryoablation procedure 3 Preparing for the procedure 3 Our specially trained medical team is eager to help patients with Preparing for your hospital stay 4 atrial fibrillation learn about the Day of your procedure 5 cryoablation procedure. Your procedure 5 This booklet introduces the After your procedure 6 procedure and what you might When will I know the results of the procedure? 6 experience. If you have further Going home 7 questions after reading this book- Follow up visits 7 let, please contact your heart physician. When can I return to normal activities? 7 Report to your physician and warning signs 8 Special instructions from your physician 8 Important numbers and addresses 9 Illustration of the Medtronic Arctic Front Advance™ Cryoballoon by Medtronic 2 Table of contents The Cryoablation procedure These tests include: The goal of the cryoablation procedure is • A CT scan one month prior to your heart The Cryoablation procedure 3 to return your heart back to normal sinus procedure. A CT scan is a sophisticated Preparing for the procedure 3 rhythm. The procedure is done by a heart x-ray system that allows your physician to view heart anatomy, including the Preparing for your hospital stay 4 rhythm physician called an electrophysiol- ogist. The physician will use cryoablation pulmonary vein. Day of your procedure 5 technique to create scar tissue on the heart. • A non-fasting blood draw, chest x-ray, Your procedure 5 This scar tissue blocks the abnormal electric and EKG, one day prior to your proce- After your procedure 6 impulses, so that your heart may beat in a dure. • An INR/Protime test will be included in When will I know the results of the procedure? 6 normal rhythm again. your non-fasting blood draw. These are Going home 7 Having the Cryoablation both used to measure how well Cou- Follow up visits 7 madin (warfarin) is working to prevent procedure performed clots, but not cause too much bleeding. When can I return to normal activities? 7 The cryoablation procedure is performed Measuring your INR helps your care Report to your physician and warning signs 8 in the hospital and takes two to four hours, team know how to adjust your medicine Special instructions from your physician 8 requires general anesthesia, and involves if needed. a hospital stay up to two days. A specially Important numbers and addresses 9 designed catheter (small tube), is inserted in Prior to your procedure, you may also be a vein in your groin and gently guided up to contacted by your electrophysiology nurse your heart. This catheter in your heart is then who will review the procedure and answer guided to the pulmonary veins. The pulmo- any additional questions you may have. You nary veins are big blood vessels that trans- will also be instructed on which medicines port blood away from the lungs to the left to take leading up to and on the day of your atrium of the heart. The pulmonary veins are procedure. Keep taking your medicines un- targeted because they are the site respon- less they tell you to stop. sible for abnormal electrical signals, which lead to the generation of atrial fibrillation. Please know that if you have diabetes, your diabetes medication may need to be adjust- If you are traveling from out of town, a ed prior to your procedure. patient navigator will contact you about the logistics of receiving your care from out of Your electrophysiologist will manage your town. anticoagulation. Your blood thinners will be adjusted and your lab results will be closely Preparing for the procedure monitored by your care team. Before your cryoablation procedure, you will need to have some tests completed, to make sure you are healthy enough for the procedure. Our patient navigator will help coordinate your pre-procedure testing. 3 Preparing for Showering and dressing for your procedure • Please shower the night before the your hospital stay surgery and again the morning of your As you think about the cryoablation surgery, before coming to the hospi- procedure, you may wonder what will tal. Please do not apply any lotions or happen while you’re in the hospital and creams after showering. Please take off afterwards. all make up, jewelry, and nail polish before coming to the hospital. What to bring to the hospital and what to • The day following your procedure, you leave at home will be encouraged to increase your activity by sitting up in a chair for meals Please Bring: and walking in the hallways. • A list of all the medicines you take, how much you take of each one, and how Drink and eat as your body is ready often you take them. Include all vita- • Your IV (intravenous line) will give you mins, herbal supplements, and over the fluids and your nurse will also give you counter medicines. sips of water. • Your Continuous Positive Airway Pres- • When you can tolerate the water and sure (CPAP) machine if you use one at feel ready to try eating, you may notify home. your nurse so that he/she can help you • Your eyeglasses, hearing aids, or other safely advance your diet. assistive devices you usually use. • Personal items that will make you feel When will I know the results of the comfortable, including toiletries. procedure? • The electrophysiologist will discuss the Please do not bring: results with your loved ones after the • Your own medicines. We will give you procedure is finished. the medicines you need while you are at • You will not know if the procedure the hospital. alone is enough to control your heart • Jewelry or other valuables. rhythm for several months. It is import- Food and drink the night and morning ant to continue your medications until before your procedure your electrophysiologist discontinues • Do enjoy a regular dinner the night be- them. fore your procedure. • Your electrophysiologist will review your • Do NOT eat or drink anything after heart rhythm at each of your follow-up midnight. This includes water, mints, or visits and will adjust your medications if gum. Do not eat breakfast, drink juice, needed. coffee, or tea. • If your doctor or nurse has told you to take medicines, take them with just a sip of water. 4 Going home and traveling trophysiologist will meet with your loved Leaving the hospital ones in this waiting room to talk about the • Your driver. For your safety, we require procedure. that someone drives you home. • Stretch. If you have a long ride, get out Your procedure of the car, stand up, and stretch your legs for a minute every hour. Or, if trav- Step 1: In the Pre-operation procedure area eling by air, take the opportunity to walk • A nurse will draw your blood to check around the airport and aisle of the plane your labs once more. when the fasten seatbelt sign is off. • A nurse will review your health history • Rest at home. You may find yourself tired and medicines. Please be sure to include when you get home. This is a normal vitamins, herbal supplements, and over occurrence. Plan to rest for the first few the counter medicines. days. • A nurse from the procedure room will clip your hair with an electric shaver. For Your procedure day males, your hair will be clipped from Hospital admission your lower jaw down to your thighs. For • Your cryoablation procedure will be women, the hair on your groin area will done in the Cardiac Catheterization be clipped. Laboratory at Valley View Hospital. • A nurse will start an intravenous (IV) The address is 1906 Blake Avenue, line. Glenwood Springs, CO 81601. • A family member or friend is welcome to come with you. • Please park in the Emergency Department parking lot. • Please come to the Emergency Department admissions where you will register at the time given by your patient navigator. • Your patient navigator will meet you in admissions and guide you to the next step. Where can my loved ones wait while I am having the procedure? When you leave for the procedure room, your loved ones can wait in the cardiac cath lab waiting room on the third floor. After the procedure is completed, the elec- 5 Step 2: The Electrophysiology procedure • Your nurse will ask you to take deep • You will be moved to the procedure breaths and do a breathing exercise us- room where you will receive general ing an incentive spirometer. This will be anesthesia. This means you will be in a done at least every two hours while you deep sleep and will not hear, see, or feel are awake and will help your lungs stay anything during the procedure. healthy while you heal. • In the procedure room, the electrophys- • You must stay in bed with your legs still iologist will put a small tube called a for four hours after the procedure. This catheter through a vein in your groin prevents bleeding from your upper leg and gently guide it up to your heart. where the physician inserted the cathe- • Using the catheter, they will look for any ter used to access your heart. abnormal electrical pathways. Then, a • After your bed rest is complete, the special tool called a cryoablation cath- nurse will help you out of bed and into eter will be used to create scar tissue a chair.