AV Node ablation (Again)

• by AndyT
• 2016-05-27 07:05:31
• General Posting
• 1231 views
• 2 comments

Hello folks, my last post here was almost two years ago when I was looking for some information concerning AV Node Ablations which it looked like at the time was my next course of action.

I’m hoping there are some new users here that have had this procedure or can point me in the direction of some advice…..or reassurance!

I have a fairly complicated cardiac history which started in 2009 with an episode of SVT caused by Wolf Parkinson White Syndrome which I knew I had and had never caused an issue, for whatever reason I ignored this assuming the SVT would stop as they always did, however it didn’t and I ended up with an emergency WPW Ablation as I had developed a Cardiomyopathy and LVF. This pathway was ablated and following this ablation I had frequent episodes of Atrial Fib. Some of which resulted in the return of the Cardiomyopathy and jaunts into LVF and organ failure.

Since 2010 I’ve had had three ablations for Atrial Fibrillation and two for Atrial Flutter including two (or was it three? PVI) It has been found through bitter history I do not tolerate high BPM and quickly end up with LVF which on at least two occasions has resulted in other organ failure issues (Liver/Kidney. now fully resolved).

During this time it was noted that following each ablation I was becoming more and more difficult to cardiovert back to sinus and there are very few medications that could hold me in Sinus, Amioderone was the most successful, now not an option due to a Thyroiditis which they think triggered one of my episodes. Following an episode of Syncope in 2014 with a heart rate of 24 BPM, thought to be Beta Blocker induced – it wasn’t, on stopping the BB my heart rate increased by 4 BPM my Cardiologist stated that a Pacemaker would be the way forward to at least control the Bradycardia and potentially in the future be ready for 100% pacing if a Node Ablation was performed. (I am 48).

He believed that as I was spending considerable time in AF which was (to be dramatic) utterly ruining my life and on two occasions had led to almost to my passing that we should consider the Pacemaker.

I was implanted in April 2014 and had a very good period of normality up until Feb. 2016. I have a Rate adaptive Medtronic biventricular device implanted, pacing at present 100% on the RA and LV lead. (RV is off at present due to a twitch that developed and the Cardiologist said I did not need it at present).

In Feb 2016 I developed a Tachycardia of 140 BPM, by pure luck (I was on an ECG monitor and the Pacemaker Device interrogation equipment) and the Cardiologist spotted that the device was actually driving a slow Atrial arrhythmia, my programming was changed to DDIR and the rate changed to 80BPM, all good she said! When I mentioned that my resting rate was programmed at 55BPM she went off to look at my ECG’s and count P-waves, she returned and stated I had a slow regular Atrial arrhythmia which she would terminate by DC cardioversion.
Cardioversion was performed and I was returned back to my 55BPM…..since then my rhythm control has been appalling, DDIR simply does not work for me, I lapse into irregular rhythms/rates at the slightest effort.

Yesterday I dropped back into a rate of 80BPM which has not terminated despite my usual cocktail of medication/hope! I have an appointment with my cardiologist in mid-June, hopefully I can last until then and my rate does not increase further leading to another cardiomyopathy.

So onto my questions if I may?

I have now decided enough is enough, I won’t be able to hold onto my job if I’m continuously having episodes of AF resulting in me being unable to work again ( I’m a nurse working Offshore),

I feel I’m hanging on by my fingertips at the moment. This AF/LVF has sadly contributed to the breakup of my 25 year marriage, she had simply had enough of it all – harsh but I can’t blame her, being told on two occasions to gather the family as I was not expected to see the night through takes its toll!

Several cardiologists have told me you are not supposed to die from AF, however I have made two very good attempts (not through choice) at it!

So the final resort in an attempt to gain some long term control – AV Node ablation, can anyone comment good or bad who has had one, knows somebody who has had one.

Searching online its either ‘go for it, it’s great” , or “do not have it done”. One particular site is very negative towards the procedure!

I’m permanently paced as it is now, what concerns me is if I would be able to feel the Atrial palpitations (even though they are not transmitted to the ventricles, I do have some fairly violent ectopic beats when I’m in my odd rhythms and these are unpleasant at best.

Is there anyone here who has had a nodal ablation and can shed some light onto what it feels like and what impact it has on life in general, I’m a fairly fit guy who cycles a lot when not in an irregular rhythm and would not like to give that up, however health comes first!
My cardiologist has stated I will be able to exercise as normal following a nodal ablation, anyone confirm or deny?

Apologies for the long post!

Looking forward to contributing to the group.
Your thoughts are most appreciated. Thanks