Pacemaker replacement in patients who already have AV node ablation

I have a biventricular synchronising pacemaker with only two of the 3 possible leads fitted due to incurable atrial fibrillation. The two leads that I have had fitted are pacing the ventricles at between 70 and 120 beats per minute. Has anyone had thier pacemaker replaced with a similar condition as I am a little concerned that my heart will stop dead when the leads are removed from my old pacemaker and that could cause sudden death. I am of course pacemaker dependant due to the av node ablation which usually leaves you with no residual pacing. On the plus side I can say that the results of this treatment -pacemaker implantation with av node ablation have been outstanding and I quite agree with some doctors who consider the job half done if the AV node is not ablated. Pete

3 Comments

hi pete

by aa11177 - 2007-07-11 04:07:37

hi Pete my name is Ashley Amaro i am eightteen years old and I have a medtric pacemaker i have had it for 5 years already lets talk

Have same anxiety as you do...

by ADalsmom - 2007-07-12 04:07:34

Hi Pete.....I had posed a question referring to your exact situation a few messages back. I was told that I should have the AV node ablated and be fitted with a biventricular pacemaker....due to chronic a-fib. My question to the EP was "what happens if the pacemaker malfunctions?" He gave no definitive answer, except that he didn't know of anyone who had problems with their pacemakers. I now have a dual chamber Guidant PM which will need to be replaced with the bivent variety....I'm not concerned about sudden death, as long as the replacement is done in a reputable hospital. I previously had an ablation (not an AV node) and had to have my PM implanted as an emergency measure since my heart had stopped. They got it going again, which is probably a relatively common occurrance. I'll be anxious to follow your posting to see if anyone else has anything to say, since I need to make the decision to do the AV node ablation soon. It's encouraging to hear that the procedure was a success for you, I was told that the a-fib would stop and that some of my heart meds could be also stopped. Where you able to stop your meds too? I'm anxious to be active again and have a life where you don't have to worry about when the a-fib is going to start. Thanks for your information.....Claudia

... not exactly that, what you wanted to know, but I think that it will be quite similar

by mikki14 - 2008-09-19 04:09:45

Hi Pete,

the true us that I haven´t had the normal PM replacement yet. I have got the third degree AV block by ablation as well. But when I was on my last (fifth) ablation, they destroyed the AV node and fitted in just external pacemaker - the last ablation took 8 hours and the doctor told me that he will give me the normal pacemaker in two days... so first I had the external one - it looks like a holter monitoring - small box inside your body with the electrode or elecrtodes fitted in.

So then I had the replacement from the external to normal one. During this operation, they leave the electode inside and do the pacing still by the external one, then he made the place for the normal one and fitted in another electrode, but still did the pacing by the external PM, when he will ready with the normal PM, he tried if everything is ok and switched on the normal one, after that all, he stoped the external one and pull it out. And that was all ;-).

Have a wonderful time!

Take care,

Misa

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