Anesthesia for Cardiac Ablation
- Jen Overton
- Jun 11
- 7 min read
Updated: Oct 21
If you’re scheduled for a cardiac ablation procedure in an electrophysiology (EP) lab, you may be wondering about the anesthesia process and how it will keep you comfortable during this important treatment. I’m here to guide you through what to expect on the day of your procedure. My goal is to ease your concerns by explaining the anesthesia used, why it’s chosen, and how it will feel, so you can approach procedure day feeling more informed and settled.
Cardiac ablation is a procedure used to treat abnormal heart rhythms (arrhythmias), such as atrial fibrillation or ventricular tachycardia. This procedure, performed in an electrophysiology (EP) lab, uses catheters (long, super skinny tubes) to deliver energy to specific areas of the heart that are mis-firing.
While you’ve likely discussed the procedure with your cardiologist or electrophysiologist, the anesthesia part might feel mysterious since you typically meet your anesthesia team only on the day of the procedure. Let’s run through anesthesia for a typical cardiac ablation together so that you can feel more relaxed before you even head to the hospital.
What Types of Anesthesia Are Used for Cardiac Ablation?
The type of anesthesia for cardiac ablation typically depends on the complexity of the procedure, the preferences of the surgeon, and how anesthesia providers expect your body to react to the effects of anesthesia medication.
The two most common approaches are monitored anesthesia care (MAC), also known as IV sedation or “twilight anesthesia,” and general anesthesia. MAC is often used for shorter or less complex ablations, while general anesthesia is more common for longer procedures or those requiring precise mapping of the heart. Below, I’ll explain both methods, their purposes, and what you can expect.
Want to know more about the different types of anesthesia? Click the image below to read What Is Anesthesia? Understanding the Types and Their Safety.
Monitored Anesthesia Care (MAC): For Less Complex Ablations
Purpose:
MAC involves IV sedation to keep you relaxed, comfortable, and drowsy during the cardiac ablation. It allows you to remain still, feel no pain, and often have little to no memory of the procedure, while breathing on your own. MAC is suitable for shorter ablations (e.g., 1–2 hours) or patients who are stable, able to lie still, and prefer a lighter anesthesia approach with a quicker recovery.
The Process:
Before the Procedure: You’ll arrive at the hospital, check in, and change into a gown. A nurse will take your vital signs and place an IV in your arm or hand to deliver fluids and sedation medications. In the preoperative area, you’ll meet your anesthesia provider (a nurse anesthetist like me, or an anesthesiologist), who will review your medical history, discuss any concerns, and confirm the anesthesia plan.
In the EP Lab: You’ll be wheeled into the electrophysiology lab on a stretcher. The lab may feel cool and busy as the team prepares specialized equipment, but we’ll keep you comfortable with warm blankets. Monitors will be placed to track your heart rate, blood pressure, oxygen levels, and heart rhythm, and adhesive patches may be applied for the procedure.
During MAC: Once you’re positioned (usually lying on your back), your anesthesia provider will administer sedation medications through your IV, such as propofol or midazolam. These help you drift into a light sleep-like state. You’ll breathe on your own, and no breathing tube is needed. Typically, the electrophysiologist will then inject numbing medication in your skin at the insertion site (usually a vein in your groin, rarely in your neck) and then insert catheters (thin tubes) through the vein, to perform the ablation. Rest assured, your heart has never been more closely monitored by everyone in the room than when this procedure is being performed, and your anesthesia provider watches over you closely to ensure your safety and comfort.
After the Procedure: Once the ablation is complete, the sedation is stopped, and you’ll wake up quickly. You’ll be moved to the recovery area, where nurses will monitor your heart rhythm and vital signs. Depending on your condition, you may go home the same day (for outpatient procedures) or stay in the hospital for observation, typically 4–6 hours or overnight.
What It Feels Like:
The IV placement may feel like a quick pinch. As the sedation begins, you’ll feel a pleasant wave of relaxation, possibly with a cool sensation in your IV. During MAC, you’ll be in a twilight state—drowsy and unaware of the procedure. Most patients remember nothing, though some may recall vague sounds or sensations, like mild pressure in the groin or neck where catheters are inserted, but no pain. In recovery, you may feel slightly groggy at first, but this clears quickly. You might have mild soreness at the catheter insertion sites, which we’ll manage with medications.
Want to learn how you can stay safe while you're asleep? Click on the image below to read How Can I Keep Myself Safe Under Anesthesia?
General Anesthesia: For Complex or Longer Ablations
Purpose:
General anesthesia, which puts you fully asleep, is often used for longer or more complex ablations (e.g., 3–6 hours) or for patients with specific medical needs, such as difficulty remaining still or complex arrhythmias requiring precise heart mapping. It ensures you’re completely unconscious, pain-free, and immobile, which is absolutely critical for the procedure’s success.
The Process:
Before the Procedure: Your anesthesia provider will explain why general anesthesia is needed and review your medical history. An IV will be placed for medications and fluids.
In the EP Lab: In the lab, you’ll receive IV medications to fall asleep quickly. A breathing tube will be placed after you’re unconscious to help you breathe. We’ll monitor your vital signs and heart rhythm closely throughout.
After the Procedure: As the ablation ends, the anesthesia is stopped, and you’ll wake up in the recovery area after the airway device is removed. You may feel groggy or slightly confused initially but will recover within a few hours. You’ll likely stay in the hospital for observation, often overnight, depending on your condition.
What It Feels Like:
Going under general anesthesia feels like drifting off to sleep, with a cool sensation in your IV. You won’t feel or remember the procedure. Waking up may feel like emerging from a deep nap, with possible grogginess or a sore throat from the airway device. You may also have mild soreness at the catheter insertion sites, which is easily managed.
Still curious about general anesthesia? Click on the image below to read General Anesthesia: The Patient Experience from Start to Finish
Local Anesthesia: A Supportive Component
Local anesthesia is used at the catheter insertion sites (typically in the groin or neck) to numb the skin and tissue where the electrophysiologist inserts the catheters. This is administered by the procedural team and complements MAC or general anesthesia, ensuring you feel no discomfort at these sites. The injection is quick and causes temporary numbness.
Are you having the Watchman procedure in addition to cardiac ablation? Click the image below to read Anesthesia for the Watchman Procedure: What You Need to Know
What to Expect on the Day of Your Cardiac Ablation
Knowing the flow of the day can help reduce anxiety, so here’s a step-by-step overview:
Arrival at the Hospital: You’ll check in, change into a gown, and have your vital signs checked. A nurse will start an IV, review your medications, and ask questions about previous health history.
Meeting Your Anesthesia Team: Your anesthesia provider will introduce themselves, explain the anesthesia plan (MAC or general anesthesia), and answer any questions. This is a great time to share concerns, like past reactions to anesthesia or worries about the procedure.
Going to the EP Lab: You’ll be wheeled into the electrophysiology lab on a stretcher. The team will position you comfortably, usually on your back, and apply monitors and adhesive patches.
Receiving Anesthesia: For MAC, a nasal cannula is placed to provide oxygen, sedation is administered through your IV, and you’ll drift into a relaxed, drowsy state.
For general anesthesia, you’ll breathe oxygen through a mask, and anesthesia medication will be administered through your IV. You'll fall asleep completely, and a breathing tube will be placed after you fall asleep.
Recovery Area: After the procedure, you’ll wake up in the recovery area (or the EP lab for MAC). Nurses will monitor your heart rhythm, vital signs, and recovery from anesthesia. You may need to lie flat for a few hours to prevent bleeding at the catheter sites. Depending on your condition, you may go home the same day or stay overnight for observation.
Why You Don’t Need to Worry
It’s natural to feel anxious about anesthesia, especially since cardiac ablation involves your heart. Rest assured, both MAC and general anesthesia are safe, well-established methods tailored to your specific needs. Your anesthesia team is highly trained and uses advanced monitoring to track your heart rhythm and vital signs while you sleep. We work closely and communicate with your electrophysiologist throughout the procedure to ensure the ablation is performed safely and effectively.
Here are a few tips to prepare mentally:
Ask Questions: Share any concerns with your anesthesia provider, such as worries about sedation, waking up during the procedure (extremely rare with MAC or general anesthesia), or the catheter insertion.
Focus on the Benefits: Cardiac ablation is designed to correct your heart rhythm, improving your quality of life and reducing symptoms like palpitations or fatigue. Anesthesia makes this possible without discomfort.
Trust Your Team: Your anesthesia provider and electrophysiologist are with you every step of the way. We want this to be very safe. We are extremely vigilant and there to ensure a smooth and safe procedure.
Final Thoughts
Anesthesia for cardiac ablation, whether through monitored anesthesia care (MAC) or general anesthesia, is designed to keep you comfortable and pain-free. By understanding what to expect, hopefully you can approach your cardiac ablation with less anxiety, knowing it’s a vital step in improving your heart health.
If you have more questions about your cardiac ablation before your procedure, don’t hesitate to reach out to your healthcare team—they're here to support you. If you have further questions about anesthesia for your procedure, check out more articles on this site. Remember, prepared patients have better outcomes.
Want to learn more about anesthesia for different types of surgeries? Click on the worryfreeanesthesia.com icon below for a list of Articles about anesthesia.
**Information provided is intended as general healthcare information for the public and should be used as a guide. This information should not be substituted for the specific personal advice recommended by your own healthcare team who are familiar with your specific health history.*
Comments