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General anesthesia is rarely performed in adult patients, in order to minimize the associated risks of infused drugs. 

 

The procedure is conducted under conscious sedation. This means that you will be feeling drowsy and keep very little memory of the procedure. As some of the radiofrequency induced lesions may be painful, powerful painkillers will be given. The first step of the procedure requires to place some plastic tubes for vascular access. This is performed at the right groin under local anesthesia.

 

The usual procedure is to introduce 2 to 3 catheters through one or two femoral veins for cardiac mapping and ablation. The mapping catheters involve multiple electrodes mounted in a longitudinal or circumferential shaft. Other configurations, including investigational designs may be used for individual situations. The ablation catheter has an irrigated tip to protect against local clot formation and allow greater energy delivery if needed (where the cardiac tissue is thicker). In the absence of a patent foramen ovale (interatrial septal hole creating a pathway between the heart chambers, found in 20 % of patients), a transeptal puncture is required to access the left atrium.

Catheter approaches

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