AFIB after AV node ablation

AV Node ablation

by Gemita - 2024-08-25 11:19:57

Hello Lyn,

Not sure what you were told by your doctors but when we need an AV Node ablation it will usually be because we have tried and failed all other treatments to try to stop AF (Atrial Fibrillation), treatments like cardioversion, rate control and anti arrhythmic medication, and finally a regular pulmonary vein isolation ablation.  

An AV Node ablation ablates the AV Node, preventing the fast, irregular rhythms of AF in the atria from passing through the AV Node to push your ventricles too fast which would be dangerous if not controlled.  However with an AV Node ablation, AF would still continue in the atria.  It will not be stopped by an AV Node ablation and a permanent pacemaker.  However the fibrillating, irregular, fast rhythms would be prevented from passing through your AV Node to affect your main pumping chambers, the ventricles, so any difficult symptoms should ease considerably or not be felt at all.  

You might though still feel or experience some symptoms, particularly since the atria will no longer be contributing to your heart function.  You will lose what is called the atrial kick which occurs as the atria contract prior to ventricular contraction. Atrial kick contributes 15-35% to the volume of blood in the ventricle. This extra volume in turn increases cardiac output by a similar 15-35%.  As we age, atrial kick tends to be a more significant contributor to cardiac output (closer to 35%). This is one reason why older patients are more affected by rhythm disturbances such as AF (a quivering of the atria rather than a coordinated contraction) than younger patients. AF causes a complete loss of atrial kick.

So to confirm, an AV Node ablation merely stops the AF or any other fast or symptomatic atrial arrhythmia from passing through the AV Node to push your ventricles to their death or to cause difficult symptoms.  However an AV Node ablation doesn’t stop the atrial arrhythmia from occurring.  It is certainly not a cure for AF but it is a last treatment option that I have considered too.  The atrial arrhythmia will continue to flutter, fibrillate or do whatever it does in the atria after an AV Node ablation but because it will be isolated and confined to the atria and prevented from passing through the ablated AV Node, the pacemaker can be set to pace at a nice steady constant heart rate and you should therefore start to feel better and less symptomatic.  I hope that will be the case for you Lyn? 

It does take time to heal and to get used to being pacemaker dependent, so please take care and don't push too hard until you feel stronger.  

AFIB

by HappyinAZ - 2024-08-25 18:59:11

Thank you SO much ! I just learned a LOT!