pacemaker

I'm a 33 yr female that had a Advisa DR pacemaker implanted back in aug 2012. The Doctor has called saying i have alot of svt going on. So he's has talked to a partner and said there is two things they can do they can try to do another ablation or they will have to do a AVnode ablation. So my question is if they have to destroy my AVNode and they do put the permanant one in if it malfuntions will i die right then or do we have time to save me?

2 Comments

AV-node ablation

by golden_snitch - 2013-01-26 03:01:17

Hi!

The His Bundle or Punkinje Fibers will kick in and provide you with a heart rate around 20 - 40 bpm, in younger patients it's sometimes faster. Might take a few seconds for the rhythm to kick in, but you will not die. I had an AV-node ablation, and my underlying rhythm is running at about 40-45bpm. Makes me feel awful, but it would give me enough time to get to a hospital in case of pacemaker failure.

An AV-node ablation should always be the very last resort. So, if there are any drugs out there you have not tried for your SVT, and/or if it's still possible to target the SVT directly with an ablation, I'd rather go for that than have the AV-node ablated. AV-node ablation ultimately leads to 100% pacing in the right ventricle. Now, there are quite a lot of studies that have shown that a lot of right ventricular pacing can lead to heart failure and occurence of atrial fibrillation; people who are paced in the ventricles suffer from these two conditions much more often than people who are not paced. So, with you being 33 and therefore having many years of pacing ahead of you, I'd not have an AV-node ablation done as long as there are alternative.

My case was a little different: I'm paced on the left ventricle; I have already had 7 ablations before I had the AV-node ablation; at the time of the AV-node ablation I was having several different arrhythmias; and I had tried all anti-arrhythmic drugs that are currently on the market. Also, I had two EP professors from different hospitals discuss my case, and they were both of the opinion that this was the way to go. Before I'd have something like an AV-node ablation done, I'd always go for a second opinion.

Best wishes
Inga

pm

by mmjackson - 2013-01-26 09:01:30

Thank you. And this is my second opinion i was seeing a dr in chattanooga tn and he just tried every med he could he didn't wont to do a pm because of my age but i have 3 kids to keep up with and was getting worse meds wasn't working for me @ all. And the fact i had no health insurance @ the time made me feel even more the dr didnt want to help me he just kept saying get insurance and based it on my age why he didn't wont to do it. So i had my pcd refer me to vanderbilt in Nashville and we have done 3 ablation and on the 3rd they couldn't get it so i woke up with the pm. But we will be asking if there any other meds that might help before we do this av node block. If not it seems that it will have to be done and its hard because i don't know how to prepare my self or my family my dads really tore up and my kids i guess don't understand and my husband just bundles it up and tries to stay strong for all of us so it's just very hard. Alot of people say i research to much and end up scaring my self even more but it also gives me a lilttle peace if that even makes sense. But thank you for your comment.

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The experience of having a couple of lengths of wire fed into your heart muscle and an electronic 'box' tucked under the skin is not an insignificant event, but you will survive.