Before ... Precautions & prerequisites
Since most patients are scheduled for elective catheter ablation, they typically report to the hospital in the fasting state early in the morning of the procedure. Because of the potential need for systemic anticoagulation during procedures that require left heart access, the timing of the procedure with respect to menses should be considered in premenopausal women. In most patients, all AV nodal blocking agents, including beta blockers, calcium blockers, digoxin, and antiarrhythmic drugs are discontinued several days prior to the scheduled procedure. In a patient with a history of coronary artery disease, beta blockers should be gradually tapered and discontinued.

You will be admitted to the hospital the day before, or the morning of your procedure. You may have several blood tests, X-rays, and an ECG (electrocardiogram). Your heart rhythm may be monitored all the time while you are in the hospital.You will be asked not to eat or drink anything for \several hours, before the procedure. You may, take sips of water with medications prescribed by the doctor.

Following preparation is required:

• A thorough history and physical examination
• Examination of the ECG at baseline and during tachycardia; this is helpful for planning the procedure
• Event monitoring, which is typically more useful than Holter monitoring in documenting the tachycardia
• An echocardiogram, which is helpful in assessing the possibility of structural heart disease
• Exercise testing, which may be useful if there is a history of exercise induced arrhythmia, but is otherwise not routinely indicated
• Other studies, including radionuclide scintigraphy, cardiac catheterization, and coronary angiography, which are performed only if indicated by the patient's clinical presentation and symptoms; a serum thyrotropin (TSH) concentration to exclude hyperthyroidism is reasonable although of low yield