Pulmonary Vein Antral Isolation (PVAI) Frequently Asked Questions

What is pulmonary vein antral isolation?

How can I be evaluated for PVAI?

What tests are performed during an evaluation?

Are there risks?

What tests will be performed before my procedure?

Should I take my medications?

Can I eat?

What should I bring?

What should I wear?

Where will the procedure be performed?

How does the doctor insert the catheters into the blood vessels around my heart?

How will I feel during the procedure?

How long does the procedure last?

How will I feel after the procedure?

Will I have to stay in the hospital?

Will I be able to drive myself home?

Will I have to take medication after my procedure?

When can I return to my normal activities?

What symptoms should I expect?

What should I expect during my follow up visit?

What are the success rates for PVAI?

What are the advantages of PVAI?

What is pulmonary vein antral isolation?

Pulmonary vein antral isolation (PVAI) is a treatment for atrial fibrillation.

Catheters with electrode tips are inserted into a vein and then into the heart. They’re guided by Stereotaxis technology to the exact areas that are causing atrial fibrillation. Energy is released to create a circular scar that blocks the pathway of the abnormal rhythm. This helps the heart beat regularly. Many patients are able to stop or reduce their use of medication following pulmonary vein antral isolation.

How can I be evaluated for PVAI?

Talk to your cardiologist or call The University of Kansas Hospital Center of Excellence in Atrial Fibrillation at 913-588-1227 or toll free at 800-332-6048.

What tests are performed during an evaluation?

We will perform a thorough medical examination to determine if PVAI is an appropriate treatment for you. This may include a number of diagnostic tests (link to new page).

After your evaluation, your physician will discuss your treatment options with you. Together, you can decide whether this procedure is right for you.

Are there risks?

PVAI is generally very safe. However, as with any medical procedure, there are risks. Special precautions are taken to decrease these risks. Your doctor will discuss the procedure risks with you.

At The University of Kansas Hospital, we use advanced Stereotaxis technology to guide the catheters safely and accurately during PVAI. With Stereotaxis navigation, physicians can safely position catheters in difficult-to-reach areas of the heart. The soft, flexible design of the catheters reduces the risk of damage to the heart wall.

The University of Kansas Hospital’s electrophysiologists were the first in the Kansas City region to use this state-of-the-art technology.

What tests will be performed before my procedure?

Before your PVAI, we will perform a transesophageal echocardiogram (TEE). This is to make sure there are no blood clots in your atrium and to check for any heart abnormalities that could interfere with your surgery. Other tests and scans may be performed if you have had previous procedures to treat your atrial fibrillation.

If you take blood thinners, you’ll be given a blood test to make sure your blood is clotting adequately.

Should I take my medications?

You will probably be instructed to stop taking blood thinners before your procedure. Your physician may also ask you to stop other medications.

Do not stop taking any of your medications without first talking to your physician.

Can I eat?

You can eat a normal meal the evening before your procedure. Do not eat or drink anything after midnight the night before your procedure. This includes gum, mints, water, etc. If you need to take medications, take them with a sip of water. When you brush your teeth, do not swallow any water.

What should I bring?

Bring a robe and toiletries. A family member can keep these items and give them to you after your procedure.

Bring your prescription medications with you, but do not take them unless you have been instructed to do so.

What should I wear?

Remove all makeup and nail polish. Leave all jewelry and other valuables at home. Wear comfortable clothes. You will change into a hospital gown for the procedure.

Where will the procedure be performed?

Your procedure will take place in a specially equipped suite in the Richard and Annette Bloch Heart Rhythm Center within our Center for Advanced Heart Care.

How does the doctor insert the catheters into the blood vessels around my heart?

Areas on your groin and neck will be cleaned and shaved to prepare for placement of the catheters. After you become drowsy, the doctor will inject medication to numb the catheter insertion sites. Then he or she will thread several catheters into large veins in these areas. You may feel a little pressure, but shouldn’t feel any pain.

The catheters will be moved into several areas of your heart.

How will I feel during the procedure?

As you prepare for the procedure, you’ll feel a burning sensation when the doctor injects medication to numb the catheter insertion sites.

Because you’ll be given medication to make you relax, you may fall asleep once the procedure begins. You may feel some discomfort in your chest when the energy is applied through the catheter.

How long does the procedure last?

PVAI usually lasts three to five hours.

How will I feel after the procedure?

You’ll probably be tired for several days following your procedure. You also might experience some chest discomfort. You should tell your doctor if these symptoms are severe or last more than a few days.

Will I have to stay in the hospital?

Yes. You will be admitted to the hospital and will need to stay overnight so your heart rate can be monitored after your procedure.

Will I be able to drive myself home?

No. You’ll need to have someone drive you home.

Will I have to take medication after my procedure?

For at least three months after PVAI, you will need to take blood-thinning medication to prevent blood clots. You must have frequent blood tests to evaluate the dosage. You also may need to take medication to control abnormal heartbeats.

After your recovery and post-procedure follow up, you may be able to stop taking some or all of your medications. Do not stop taking any medication unless directed to by your physician.

When can I return to my normal activities?

Most patients resume their normal activities within two to three days. Don’t lift anything that weighs more than 10 pounds for a week after your procedure.

What symptoms should I expect?

You may have short episodes of atrial fibrillation during the first two months after the procedure. This is common, since the procedure can cause swelling of the heart tissue. You should make a note of these symptoms and inform your doctor to see if any additional monitoring should be done. After your heart has healed, these symptoms should go away.

Please call your doctor immediately if you have:

  • A temperature of more than 101 degrees
  • Signs of infection including redness, swelling or drainage
  • Atrial fibrillation symptoms

What should I expect during my follow up visit?

You should schedule a follow-up visit three months after your PVAI procedure.

During this visit, the atrial fibrillation care team may perform these tests:

  • Blood tests/lab work
  • Electrocardiogram (ECG)
  • Echocardiogram (Echo)
  • Spiral computed tomography (CT) scan

What are the success rates for PVAI?

PVAI has been performed at The University of Kansas Hospital since 2005. We now perform up to five PVAI procedures each week. Success rates can be as high as 90 percent for patients with structurally normal hearts and occasional atrial fibrillation. A success rate of 60 percent is more realistic for patients with more severe heart disease and permanent atrial fibrillation.

What are the advantages of PVAI?

For many patients, PVAI is a permanent cure for atrial fibrillation. Many patients are able to stop using medication after this procedure.

The PVAI procedure is minimally invasive, which means less risk, reduced pain and a quicker recovery than with open- heart surgery.

Physician Spotlight


Chad Cannon, MD

Clinical Focus
Emergency Medicine

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