Hello, I've just subscribe to HealthUnlocked, this will be my 1st posting. Has anyone had an AV ablation/pacemaker done? how successful was

I have had episodes of paroxysmal or persistent AF for the last 4yrs, I have tried all available medication without success. I've now come to the end of the line, a AV node ablation has now been mentioned, I'm due to see the EP specialist next week. I'm not happy about having one done, hoping there's someone among you that has & can give me positive feedback.

16 Replies

  • I don't know what an AV ablation is but I've had two RF ablations. First one, 8 years ago was a complete and immediate success and the second, last year, they couldn't find anything; the arrhythmia had gone away! Both were a breeze and I am not bothered about having a 3rd this year. Give me an ablation rather than drugs any day.



  • There are different kinds of ablation, Bob or Beancounter are yer men for knowing the whole story... Ablation of the AV node stops the body's own (in this case faulty) rhythm control mechanism, as I understand it, but it means you have to have an artificial one instead - a pacemaker. These are supposed to be very good nowadays and the batteries last for years and years. But if you have worries, talk them over with the EP specialist, they should be able to give you the full picture. I'm sure there must be people on this forum who have had the procedure... Good luck!


  • An AV node ablation is usually a last resort, not a first procedure. You would be reliant on a pace maker. I would only consider a standard PVI RF ablation first. Can I suggest that you need to research these options (look at the AFA website) and only agree to an AV node ablation when you fully understand what it involves and other options have been ruled out.



  • Hi Bob thanks for responding to my query. I had an angiogram done it showed I had a diseased back wall so a pulmonary vein isolation wasn't possible. I suffer from terrible side effects from the medications given for AF. Have seen the EP specialist who recommended a pacemaker with high dose metoprolol, I was given this medication once before which sent me into heart failure I was them switched back to Sotalol which I tolerated well. Since I've had my pacemaker in, which was in October I was put on 190mg metoprolol which made me terrible breathless, I have now gone back into heart failure. I'm due to see my EP specialist next week, I'm not happy with what he's going to say. Do you know anyone who's had the AV Ablation?

  • I was on warfin for 7 years then had a pacemaker fittered i can recker mend has i have had no problems. I started warfin in 1995. Had some complecation untill i had my pacemaker fittered but now have no problems at all.I am on my second pacemaker now and fill realy fit .I go out for walks of 3 miles or more.


  • Hi Bubbles and welcome to the forum.. I have a feeling that you may be confusing ablations. A pulmonary vein ablation either RF or cryo aims to stop the rogue impulses from entering the atria and causing the fibrillation. An AV node ablation burns away the body's natural pacemaker to be replaced by an implanted electronic one. This is usually a last resort as you would be totally dependent on the machine.

    What is important to understand is that an AV node ablation will not stop the AF which you will continue to experience. Your heart beat will be normal , controlled by the pacemaker which only works on the left ventricle but the left atria can continue to beat the fandango if it wants to. Your symptoms of tiredness . fainting etc will be a thing of the past but your small furry animals will continue to roam freely. Mumknowsbest has had this procedure but only after three failed RF ablations and is considering a fourth RF ablation as the animals seem to be breeding.

    There are loads of fact sheets on the main website which I commend to your attention.

    For what it is worth a normal RF or cryo ablation is a walk in the park and many people who came here worried now wonder why. Be aware that you may need more than one to rid yourself completely of the mongrel condition and it does take time for the heart to settled down afterwards. maybe three to six months all told. .

    Hope that helps.


  • Third sentence-- I meant to say pulmonary vein isolation ablation. Yu really wouldn't want to ablate the veins! lol

  • Hi bubbles170,

    If you are still only Paroxysmal AF then either rf or cryo-ablation would be the best option rather than Pace and Ablate of the AV node. Rf or cryo-ablation is treating the source of the AF in the pulmonary vein or left atrium. Pace and ablate would usually only be done when ablation of the atrium or drug control has not been successful. My cardio had never suggested ablation or referred me to EP. It was only after attending the AFA patients day a couple of years ago that I asked to be referred to EP. The EP said that I had been in permanent AF too long and the chances of success of ablation were very low and the risks quite high. So better to get the PVI or left atrium ablation done first.

    I have 1st degree heart block which is part way to what happens with pace and ablate, (the ablate part), so the I am not normally aware of the AF apart from the fatigue and some chest discomfort on exertion. My resting heart rate is normally around 45 and the EP doesn't think a pacemaker is required at this point. With the AV node abaltion it creates complete heart block, i.e. completely blocks the electrical signals from the left atruium to the ventricles and hence the pacemaker is required. There is a natural pacemaked in the ventricles but that only generates a very slow pulse and is not sufficient to allow you to do much but would keep you going if the external pacemaker failed. However pacemakers today are extremely reliable devices and last for many years.

    So in conclusion, go for the PVI or left atrium ablation as a first option before opting for the AV node pace and ablate, BUT, as always be guided by your EP specialist.


  • I have had AF for sercrentian from 1995 was told i may had it all my life. I am still on warfin which i was told will be on it for the rest of my life. As i said in my last message ifill fine


  • Thank you for responding to my request. Unfortunately I had a coronary angiography done in Feb '13 which showed heart disease on the back wall of the heart ruling out a pulmonary vein isolation.I been through most AF medications unfortunately I suffered bad side effects from them. I had a pacemaker put in, in September, taken off Solalol in exchange for 190mg Metoprolol, also taking 360mg Diltiazem,( I had been on high dose metoprolol previously which resulted in me going into heart failure,so I was switched back to Solalol which I was happy on.) Now once again my Cardiologist knowing high dose Metoprolol doesn't agree with me wants me to try it again - result on Christmas Eve I went back into heart failure. I'm due to see the EP specialist next week, he previously suggested the AV Ablation but my cardiologist wanted to try the pacemaker with Metoprolol first. What choice do I have now?

  • Thank you to all of you that responded to my query on AV Ablation/Pacemaker. I had an angiogram done which showed it wasn't advisable to have a pulmonary vein isolation done. I've tried nearly all the AF medications without success. Seen the EP specialist who recommends the above, I'm due to see him next week, knowing what he's going to advise. I wondered if there was anyone who had had it done, that could reassure me how successful it had been.

  • I was in the same boat as you and was offered another ablation or a pace and ablate planned for 3 months after, I was given 3 lead Pm last June, up to now no Af so decided not to ablate. I had started collapsing that is why given PM

  • My EP has told me to avoid rate and ablate like the plague because it is the last resort and treatments for AFIB like ablation are improving.may depend on your age I am 68

  • thanks Parkie 10 for your reply. I do realize that it is a last result, but when all else has failed & your quality of life is getting less & less what have you got to lose? I'm 75yrs young & have enjoyed my life up to now, hate that I can't do too much & lie around part of the day

  • Bubbles you say you have tried nearly all the medication- If Metoprolol has led to heart failure it doesn't seem a good plan to have that again but I wonder if there isn't some other medication that could be tried with the pacemaker?? Make sure your cardiologist ( and perhaps a second opinion should be sought- you are entitled to this-) has really looked at all the possible options.

  • Thank you rosyG for your response. I did get a 2nd opinion in a roundabout way, I was taken to hospital on a Friday night, fortunately I was seen by the on -call cardiologist the next day. He reviewed my medications & took me off Metoprolol in exchange for Bisoprolol, I live in NZ evidently Bisoprolol only recently got introduced to us in the last few years. I seem to be doing a lot better on this medication except I still get SOB.

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