What is it like to have this surgery?
Institutions performing these procedures will differ somewhat. At Sacred Heart Medical Center Riverbend, you should expect to come to the hospital on the morning of your procedure, and be admitted to Cath Prep Recovery or the Cardiac Surgical floor. From there you would go to the operating room, where the anesthesiologist would put you to sleep, and put you on a ventilator. Sometimes epidural anesthesia is used. The cardiac surgeon (David Duke, MD) performs the operation, and the electrophysiologist (James McClelland, MD) makes sure that conduction between the atrium and pulmonary veins is gone, and the nerves that can cause AF are eliminated. The surgery requires a three inch incision between the ribs, with two smaller ones less than an inch long, on each side of your chest. The operation takes about 4 hours.
When your surgery is complete, you go to the Post Anesthesia Care Unit and subsequently the Intensive Care Unit or the Cardiac Surgical Floor (OHVI-4). You would have tubes in the incisions in the chest to take care of any drainage for another day or so. There is some discomfort with the incisions, which may last several days or longer; you would likely stay in the hospital about four days.
Blood thinners are begun as soon as possible, usually the first day after your surgery. The heart rhythm medicines that you were on are usually continued for the first eight weeks following surgery. Anti-inflammatory steroids (prednisone) are given to prevent inflammation around the heart (pericarditis); you will go home on several medications, including prednisone, blood thinners, medicines to prevent AF, and other medicine that you may have required prior to surgery. The prednisone and antiarrhythmic medications are soon stopped, but blood thinners may continue to be required.
Some AF may persist for the next 6 weeks or so, while the healing process completes. The recovery period varies, but most people would not resume work for at least two weeks. You will be followed in clinic by both surgical and electrophysiologic members of the team; for more specific information about the timing of the visits following the procedure, read Before and After.