AV Node Ablation with Pacemaker

I am scheduled for an AV Node Ablation and the placement of a Pacemaker on February 24th. This is a last resort to try to regulate my heart rate (I have A-Fib and flutter). I do not tolerate the drugs and prior ablations have not worked. We have tried all the "let's try this" choices and this is the only thing left to try.

I guess I just need some feedback from those that have had this procedure and some information on what to expect. I have talked with my surgeon, my cardiologist, and my PCP and they have done an excellent job of explaining everything, but they are doctors who are advocating this procedure. Now I need information from real people.

I appreciate any information and experiences that you can provide. Thanks--Liz

6 Comments

Afib is tricky

by Theknotguy - 2015-02-19 02:02:45

The afib side is tricky. Basically they said there were two ways of treating my afib, rhythm control and rate control. Rhythm control didn't work for me so they did rate control.

Problem was, if they didn't treat my afib/flutter my heart would go into afib with RVR and it would kill me. If they gave me drugs for afib, it would slow my heart down to where it would stop beating and it would kill me. So I was between the proverbial rock and a hard place. What they did was to give me drugs to slow my heart enough to stop the afib then use the PM to bring the heart rate up to a speed to keep me alive.

Problem is, the PM by itself doesn't control afib. So I can and do go into afib sessions. It was over a hundred sessions last year with some lasting over 24 hours. That's the bad news.

I have a Medtronic PM which has APP - Atrial Preference Pacing. Atrial Preference Pacing is a software program in the PM that monitors for afib. At the five month mark I had them turn it on. While it wasn't an instant change, over a seven month period the APP helped reduce the number of afib sessions I had.

There has been some discussion on the forum the APP didn't make the difference in my afib sessions. It could have been changes in my new heart drugs. It could have been the combination of heart drugs and the APP. Maybe the PM helped reduce afib. Whatever.

The end-of-year printout with my PM checkup showed a noticeable improvement of my afib. Both the graphical printouts and the numerical printout showed a decrease in the afib sessions. I could both feel and see the difference.

Suggestions for you: One more round of questions for your doctors. Ask about rhythm and rate control. Ask about the Medtronic PM with APP. See what they tell you.

While I still do go into afib, the sessions aren't as frequent, quite often they aren't as intense. In any case dropping from as much as one afib session per day to one afib session per month is a tremendous change. Needless to say I'm ecstatic.

While no one can guarantee what worked for me will work for you changes in medical science does give you hope for the future.

My best wishes go out for you.

i'M GOING ON 4 1/2 YEARS

by Bill T - 2015-02-19 04:02:31

My afib was ongoing and getting worse for 15 years. Had all the beta blocker allowed and a PM to increase heart rate. Had the AV Node Ablation in the summer of 2011 and upgrade to CRT-D. I still have afib, some episodes lasting 12 + hours. For the short episodes, less than a several hours I don't even notice them, the long sessions still make me feel lousy but so much better than before.

As a side benefit, my EF was in the low 30s and the CRT brought it back to normal.

Best of luck with your procedure.

Bill in NW Arkansas

Feeling Great!

by 1bcampbell - 2015-02-19 04:02:38

Hi Liz

April 8th 2015 will be my first anniversary. I had a-fib for 20 years and was on Matoporal for the entire time. About 2 years ago I started blacking out. Heart halter showed several 5 to 6 second pauses at night. Long story short...I was rushed to hospital with 3 degree heart block. I had the ablation and a Boston Scientific pacemaker installed within 2 hour of arriving. I am 100% dependent on my pacemaker. I'm not sure if I still experience a-fid because I never feel it. I feel better then I ever have!!! I am a 61 year old female who is active and goes to the gym 3 times per week. I am very busy with a full time job and very involved in my church. My pacing is set at a low of 80. I have lots of energy and I have gotten my pulse up to 160 while exercising with no problems. My surgery happened on a Tuesday and I was back to work the following Monday. Stay positive and you'll do great!
B

Thanks

by lizs101 - 2015-02-19 06:02:45

Thank you all for the information. I am facing this procedure with the expectation that it will work and I will feel better than I have for along time. So positive thoughts are not a problem for me despite the fact that I am scared.

I will check on the type of pacemaker they plan on using and the APP program. Believe me we have been through rate and rhythm control and discussed it several times with me coming up with new questions almost every time I see my EP.

Below is a little history on my trip with A-Fib and flutter. Compared to most I have been dealing with this for only a short time, the problem is that I am in constant A-Fib and the ablations worked only for a couple of months and a Cardioversion only for a couple of days. The medications make me so fatigued that I cannot function.

9/18/2012 A-Fib diagnosis; 11/28/2012 Ablation; 2/22/2014 A-Flutter diagnosis; 3/21/2014 Cardioversion; 07/03/2014 Ablation; 11/07/2014 Cardioversion; 1/13/2015 Started on Tikosyn; 1/23/2015 taken off Tikosyn with recommendation for AV Node Ablation with Pacemaker

I thought I would tell you

by janetinak - 2015-02-21 01:02:01

my experience with AV Node ablation & PM. When I 1st got Afib in 01/99 I & my cardio tried every med known at the time & any that came out in the almost 2 yrs we tried to control it. I had severe symptoms-fatigue, sob, etc. Could barely drag myself thru the day & work. Had 5 cardio conversions w/o any luck so I decided on the only option at that time was the AV Node ablation & a PM. I had it done in Oct 2000 & am now on my 3rd PM. I am so glad I did it. I am still in Afib, take Coumadin for possible clots, & ventricle paced by PM. I have had my life back since that procedure & feeling good. Private message me if you have any questions.

Janet

Me Too...Similar Story

by PJinSC - 2015-02-26 03:02:06

I went 10 year with A-fib and then A-flutter through the same gauntlet of medications, ablations, multiple cardioversions, and then insertion of a three lead CRT-P followed a month later by AV Node ablation and turning the PM on and adjusting it. I am 99.1% paced. I am going into my second year and am feeling much better. The Atria are still in A-fib and are out the range of the PM lead there. The two Ventricular leads are controlling me at a 70 bpm setting. I still feel PVCs now and then and an occasional fluttering, but am reasonably active and have no serious conditions and getting stronger. I was able to go off Metoprolol Succinate finally, and am only on Lisinopril to control hypertension and Xarelto for anticoagulation.

You will find a lot of good (and some not so good) information in this Forum about electrical interferences and so forth, but I have yet to experience anything that I could definitely say was cause by interference.

Follow your Doctors' orders and good luck!

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Intel inside is your motto.

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I, too, am feeling tons better since my implant.