By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.
A postablation case was a rarity for me, even as an experienced ICU nurse. While floating to the cardiac ICU one day, I received a patient from the cath lab who had just undergone the procedure for recurrent atrial fibrillation.
My colleagues, experienced in electrophysiology care, gave me a heads up—“Just watch her rhythm. That’s the most important thing.” But no one could provide a standard protocol for me to follow in her care. While I had the usual critical care protocol for monitoring patients, and the orders given to me for this patient, before she arrived I did a little online searching to determine how to tailor my care for her needs.
The catheter ablation procedure involves electrical ablation of tissue around the circumference of the pulmonary veins, the most common site for atrial fibrillation triggers (A). Lesions are created through the use of an irrigated radiofrequency ablation catheter (B). Illustration by Anne Rains.
I set my patient’s alarms, and myself, on high alert for arrhythmias and treated my patient’s insertion site as I would a cardiac catheterization site—monitoring it for bleeding, signs of hematoma, or infection. But a protocol for care would have been welcome, as this cardiac electrophysiology procedure can often lead to unexpected complications that require immediate action—ones you might not originally think of, like a stroke or flash pulmonary edema.
The lack of standardized care guidelines for nurses after an atrial ablation is a good reason to read one of AJN‘s October CE articles, “Catheter Ablation of Atrial Fibrillation.” Coauthor Linda Hoke discusses what to expect, how to prepare, and complications to avoid when caring for patients having this procedure done.
While my patient smiled throughout her entire postprocedure care, and her procedure was successful, it would have been helpful to read this article in preparation. It provides a concrete plan of care for postablation patients that might serve as a resource for nurses receiving postprocedure patients—inside and outside of the intensive care unit. Click the above link to read the entire article, and take the CE test afterward if you need the credits.
my husband had ablation done for atrial fib in 2012 by a well known cardiac electro physiologist from Austin Texas. My husband converted to NSR right away, now he is back on his normal self and his cardio electro physiologist said not to see him again unless atrial fib comes back, it has been 3 years now, the best thing that ever happened to us.,now he is driving our motor home all over US, fishing and hunting.