av node abation

Hi
I am new to this site. I had an AV node ablation in Dec 2013 and even though my heart rate feels normal I still can't walk any distance without having chest pain and shortness-of-breath.
I have been on short term disability and want to apply for long term but my cardiologist says he does not think I am disabled.
Do any of you guys experience the same symptoms? I feel like I need a scooter and I am only 57 years old.

Thanks,
Cindi

4 Comments

It takes some time

by Theknotguy - 2014-02-04 04:02:15

It does take some time to get over the trauma your body received. You had an ablation which messes with the heart and that will take some time to heal.

I had a lot of trauma prior to receiving my PM. It's 120 days since I got my permanent PM and I still get angina when my heart rate goes to 115 bpm. Things are getting better as, at 90 days, I was getting angina at 100 bpm.

The change doesn't sound like much but at 90 days I'd do 40 minutes then go home and take a nap. At 120 days I can go 40 minutes, then go the rest of the day. So there is a big difference.

I don't know if you qualify for cardiac rehab? Will your med insurance pay? Cardiac rehab can help with SOB and angina.

I'll let others chime in to see if they have alternate views, but I feel you've got to give yourself more time to heal.

Theknotguy

Afib?

by golden_snitch - 2014-02-04 04:02:46

Hi Cindi!

Did you have the AV-node ablation because of atrial fibrillation?

One thing is that if you've had it for afib, your atria and ventricles are still beating out of sync: atria fibrillating, ventricles beating at a good and steady rhythm. Hence, you lose the "atrial kick" because the atria are not pumping effectively. Now, that kick doesn't make up for much of the heart's overall function. BUT if you have a weak heart with the ventricles not pumping well plus you lose the atrial kick, that can definitely make symptoms of heart failure worse or lead to first occurence of these symptoms.

Another thought is that you are now paced 100% in your right ventricle. In some patients this leads to heart failure, because the ventricles are beating a bit out of sync: right ventricle gets stimulated a little earlier than the left. Happens in some patients, in others it never does. It doesn't depend on how long you have been paced in the right ventricle, either. This observation of right ventricular pacing leading to heart failure has been made in patients who had been paced only for weeks or months as well as in patients who had been paced for 10 years or so.

Do you know what your EF (ejection fraction = important parameter to evaluate how well the ventricles are pumping; normal is anything above 60%) is? If you cannot remember when your last ultrasound of the heart was, it might be time to get this done again and see, if your heart's function has deteriorated. The symptoms you are describing would fit. But, of course, this is only one possible explanation. It's just a guess based on the fact that most AV-node ablations are performed in Afib patients, and based on what is known about the effects right ventricular pacing can have.

Best wishes
Inga

av node

by mike thurston - 2014-02-04 07:02:31

Sorry you are having a tough time. I am in permanent afib (7 years), totally ablated, 100% pm dependent with an ICD, about 1/3rd of my heart muscle is dead. The other comments are very good. I am not sure of your pm setup but a CRT with a lead on each ventricle has been very good for me. I still have to fight fatigue but can do a lot. Cyclling, weights, swimming etc. If you are single paced I would ask your EP about it. Also get a good tech involved who is experienced with adjusting beyond the basic session. Some folks have the Boston Scientific with minute ventioation and that is often beneficial. Best Wishes.

CRT set up

by Anne53 - 2014-02-04 11:02:22

I understand how you are feeling about exercise tolerance. Perhaps you could suggest to the docs or PM nurse that they check the initial settings on the PM to make sure that the rate response is turned on and responding.
I had an AV node ablation & CRT pacemaker implant in Dec 2013 for afib & heart failure. We found that my exercise tolerance was way worse than before. At the Pacemaker clinic the RN was mystified but(thank God) she called the manufacturer and they figured it out. When the pacemaker was implanted the implant detector was not turned off; so although the readout said rate response was ON it actually did not work. Now things are going great, I can even run down hills & rarely nap.
So I suggest that you contact your cardio docs or pacemaker techs.
Good luck & hope it all works out.
Anne

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