AV node ablation and pacemaker

I had this done as drugs were not effective and my shortness of breath increased.  My pacemaker is set at 70bpm.  I am due to return to my EP next month after having a further pulmonary vein isolation which left me after 8weeks back in AF and breathless.  It is the breathlessness that is my big problem which only shows itself on exertion.  I am fine whilst sitting and laying flat.  I feel very  despondent that the breathless continues after the work performed.  Has anyone any experience of this and advice to where I shoud be looking.

3 Comments

I'm confused

by AgentX86 - 2019-10-01 08:42:21

If you already had an AV node ablation, why are they just now doing a PVI? The whole idea of the AV node ablation is to disconnect the ventricles from the atria. What they're doing shouldn't matter. I've been in permanent flutter for a couple of years now. After the AV ablation, I don't feel it.

This sounds strange. I'd want so.e specifics from my EP before I went further. Maybe a second opinion.

Confused

by bilboesylvia - 2019-10-02 05:15:44

I had a AV node ablation after having a clot in my heart back in 2016 which didnot resolve at that time. and progress could not be made. This procedure has an 80% chance of sucess but I was in the 20% that didn`t.  As the breathlessness was still a large problem my EP sugested a PVI after a check to see if the clot had resolved. This was in an effort to resolve my breathlessness.  He gave it a 50% chance of success due to my age(75) and the length of time I had been in persistant AF.  This again didnot resolve this problem so I will see what he suggests on the 7th October.

This EP has thirty years of experience and heads up the team of EP.  He also lectures and teaches. His credentioals are impecable so I can only think to have a second opinion will muddy the waters.  

I am one of those patients who is difficult to treat with any degree of sucess.  My problems are all electrical related and I have no structural problems and clean arteries.

the importance of the atria

by Selwyn - 2019-10-02 14:26:50

https://www.ncbi.nlm.nih.gov 
by JS Alpert - ‎1988 - ‎Cited by 168 - ‎Related articles
Stroke output declines by 20-30% in normal individuals with loss of atrial function. 

Better to have functioning atria if possible!  Otherwise no one would bother!! ( cardi-version, ablations, medication etc.) 

May sure your pacemaker rate response is switched on ( there are a variety of settings for onset and offset).

You know you're wired when...

Your favorite poem is “Ode to a Cardiac Node”.

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