AV Node Ablation

I had an AV node ablation and a dual pacemaker implantation in late July this year, following two failed catheter ablations for treatment of paroxysmal AFib and then atrial flutter.

I need to understand how the pacemaker works and what to expect from it, in that now the ventricular rate is controlled 100%,by the pacemaker, will I ever experience arrhythmia again? I know that the atria will continue in AFib (I have to continue lifelong anticoagulation) but that the chaotic signals will not be transmitted to the lower heart. Therefore I should expect a lessening of awareness of what was for me, very symptomatic AFib.

I am puzzled as to why, a few weeks following the procedure and again one week later, I experienced all the old symptoms for several hours, including the erratic pulse rate and feeling ill as before. Surely this could not now happen? I did visit the clinic where they made an adjustment and so far, I have not had this happen again.

I would like to know if the the progress of the Afib can still be monitored (ie has it become worse or even permanent?) and is merrily going its own irregular way causing havoc in the atria, whilst the bottom ventricles continue to beat in a sinus rhythm.... ie, can the rhythm of my heart now be affected in any way by the AFib?

I sometimes get off days where my head pounds and blood pressure rises, my colour vanishes and I am light headed. This may or may not be something to do with the previous description. I just don't know enough. The arrythmia nurses are not experts and my GP knows very little, so I am hoping here someone will have some info and advice for me.

3 Comments

AV Node Ablation

by JoMarie - 2014-10-15 08:10:25

Maybe I should ask more directly. Following AV node ablation, does the pacemaker always keep in paced sinus rhythm or can it be irregular?

AV Node Ablation w/A-Fib

by Many Blessings - 2014-10-16 10:10:30

Hi JoMarie,

I have been in chronic A-fib since 1987. Prior to my CRT-P with an AV Node Ablation a little over 2 years ago, my A-fib was at a very high, "uncontrolled" rate 24/7. I am still in chronic A-fib (24/7), but it is at a "controlled" rate now, paced at 80 bpm. My range is 80-150.

Prior to my procedure/CRT-P, my EP doc and cardio doc all told me I would still be in A-fib afterwards, and I am. It may depend on how bad your situation was prior to your procedure, whether or not the A-fib will continue. Do you have a CRT-P? Or, a regular PM? If it's a CRT-P, it should help.

Av Node Ablation

by JoMarie - 2014-10-17 08:10:34

I think the difference for me is that the AV node has been ablated, that is, there is no passing of impulses from the atria to the ventricles. Therefore I would have thought that the ventricles which are completely controlled by the pacemaker, would just keep on at the same rate regardless of what is happening in the upper chambers, ie Afib.

So then what I am trying to find out is my pulse now just a reflection of what the pacemaker is doing and will beat regularly on its setting, or can my pulse become irregular again (as it once did prior to an adjustment).

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