AV Node Ablation

AV node ablation

by atiras - 2024-06-18 15:37:59

I had one in 2018. Trudged into the hospital unable to walk far. Hopped skipped and jumped out. I do know others didn't have such an improvement - depends on other conditions they had.

The actual procedure was less uncomfortable than having a pacemaker for the first time, although lying flat for hours afterwards was tedious. .

What my EP told me about an AV Node ablation

by Gemita - 2024-06-18 15:44:53

I was offered an AV Node ablation in 2018, six weeks after my pacemaker was implanted.  

If I may, I would like to share with you what my EP told me about an AV Node Ablation, just so that you can get another view to help to reassure you since I see you have definitely decided to go ahead.  Only you can possibly know the difficult symptoms you are getting and what you can and cannot tolerate, so I would support you in whatever decision you make.  My EP confirmed:

"You ask a very good question about whether you would have symptoms following an AV node ablation which is not a perfect treatment as you would still get AF, but you are aware of this.  However, the main symptoms that I suspect you are experiencing are probably due to a rapid heart rate and irregularity of your heart beat.  Both of these would be eliminated by an AV Node ablation which would prevent the high heart rates and irregular rhythms from passing through the AV Node and pushing your ventricles too fast.  However when you are out of rhythm in the upper chambers, you might have some minor symptoms although I suspect you would not have a major drop in blood pressure as you do now.  In summary, I suspect you would be significantly better and would never feel the need to attend hospital during attacks.

An AV Node Ablation is successful first time in the vast majority of patients (95% or more).  We do very occasionally have to repeat the procedure but this is very uncommon.  The procedure itself only takes about 15-20 mins.

There is a small risk following an AV Node Ablation to develop heart failure.  In the unlikely event heart failure were to occur, we would offer you an upgrade to a more sophisticated pacemaker that should improve the pumping of your heart."  

(In your case you already have synchronised pacing, so there shouldn’t be a problem).

I was also told that I could stop anti arrhythmic and rate control meds, but would need to remain on an anticoagulant.  Of course the downside is that you would become pacemaker dependent, but pacemakers are so reliable today and most of us have an escape rhythm that would keep us going until we received help.  It all comes down to symptoms.  If you are so symptomatic and have tried and failed to stop your AF with both regular pulmonary vein isolation ablations and strong anti arrhythmic meds like Amiodarone, then you are in my opinion a candidate for an AV Node ablation