Pacemaker with AV Node Ablation

[JK80]

I was diagnosed with A F and had Ablation 2 years ago witch lasted 8 hours and according to my consultant was extremly difficult. It took several weeks before I could lead a normal life My ablation was partial successful And now only have AF every 6 weeks or so I take 25 Atenolol Ezetrol 10mg and Asprin,

I use Propafenone 150 mg as pill in the pocket and normal take 3 tablets over 18 hours before AF subsides reasently my attacks are becoming more frequent so my life is difficult to book or plan things in advance.

My Cardiologist has suggested the next step would be a pace maker with AV Node Ablation this seems rather drastic.

At a Beat it meeting recently the consultant suggest I had a second opinian from an Electrician his words.

My appointment is August 12 with my consultant in Nottingham

I hope this make sense from a 71 year who loves life .

[jennydog]

I am in potentially the same position as you if my AF gets worse.

I have joked that I have become very fond of my AV node now that I know that I've got one. The thought of having it ablated and becoming 100% dependent on a pacemaker is daunting. I have read recently that it isn't completely destroyed so that it can still cope short term were the pacemaker to fail.

I have been much heartened by reports of others on this forum who have new leases of life once their pacemakers are fitted.

Please let us know how you progress.

Very best wishes.

[JK80 in reply to jennydog]

Thank you for your message will keep in touch

[Alphakiwi in reply to jennydog]

I had pm put in 3 yrs ago. The decision by another cardio that i was handed over to has resulted in 3 yrs of on off misery while seemingljy testing all drugs available. It looks like i may be back to the hospital to finish the original job. Maybe that was because of covid taking up the specialists.Anyway i dont have many qualms about it anymore . At 82 maybe i can get back to my musicianship and love of cycling which affib has really been denying. All the best to you in your decisions.

[BobD Volunteer]

I love life as well and for that reason would urge you to speak to your doctors about proper anticoagulation. Aspirin is about as useful as a chocolate fireguard at stopping strokes in AF .

I would agree that you maybe need to have a detailed discussion with your EP.

Bob

[JK80 in reply to BobD]

Thank you for your helpful message I agree completely about Asprin so will be discussing this on the 12th With regard to my EP the only person I have seen is my consultant who is very well thought off and lectures all over the world on AF

The EP I was recommend too was at a different hospital by a consultant at The Beat it meeting

Kind regards

[BobD Volunteer in reply to JK80]

If this guy is the one who did your ablation then he is an EP. Names would help. Second opinions can be helpful or they can confuse I think depending on which answer you are looking for.

[JK80 in reply to BobD]

Hi Bob, I am under Dr AJ Ashan at The City Hospital in Nottingham the EP I was recommend to see was Peter Stafford at Glen Field Hospital Leicester

It was the consultant who gave the lecture at Beat it at Grantham that suggested I should take a second opinion if I was concern AV node ablation was my only alternative

Thanks for help Jenny

[farmerwalt]

Had a pacemaker fitted a week and a half ago but didn't require the AV Node ablation. There is a natural pacemaker in The Bundle of His, the connections between the AV node and the ventricles, that will keep your heart beating although at a very slow rate. At least it buys you some time if the pacemaker should go faulty. The modern pacemakers are very reliable and the battery in them should last between 6 and 10 years and give plenty of warning when they are getting near replacement time. It is also one reason to have the yearly checks on them.

Having had sever TIA's, pre warfarin therapy, I would echo Bob's comments about getting proper anticoagulation and seeing "the electrician", EP.

Walter.

[JK80 in reply to farmerwalt]

Thank you that's most helpful Jenny

[wendicarro]

Hi,

Think you certainly need to be on warfarin or something ,My quality of life was becoming worse at 48 after three unsuccessful ablations. I had a pacemaker fitted last year was still no better and went on to have an AV node ablation in March gone ,I do not take anti arrhythmic medication anymore and I have my life back, I do however take blood thinners and medication to help blood circulate better but small price to pay.

Hope that helps,

Wendi

[JK80 in reply to wendicarro]

So helpful thank you,lovely to hear you are feeling well and have your back

Jenny

[Teignfisher]

I have had a bi-ventricular pacemaker fitted in April and due to see my EP in late November after another episode of AF . It was very good to read your positive comments on the outcome.

It is life after AV node ablation that concerns me as normally I am OK only when I AF I always end up in A&E. I don't want to jump out of the frying pan into the fire

[Lee-J]

After a long history of a fib, flutter, six ablations and two years doing 148 non stop, no drugs worked. AV node ablation was only option to save the ventricle which was struggling. I asked before the node ablation to tell me what, if any, my escape route was before PM was switched on. After ablation I could feel I had gone to a really low rate and was left for a few minutes so they could give me an answer. It was 40. I was switched on at 80bpm and during activity it can go to 130bpm. It was resurrection. It’s been three years now and just yearly visit to physiology. I do everything now to climbing, gardening, no jobs really I can’t do. Mine is a Medtronic Solara MRI safe CRTP. It’s been in three years and last check in March showed eight years of battery life still left. Rare to fail but the three options following failure will ensure you will get help and a temporary lead can be inserted until a new PM can be fitted. I have a family friend, Consultant EP, who deals with all types of PM’s and said in all his years of practice he has never lost a patient due to CRTP or PM failure. He didn’t fit mine, as too close a relationship, but counselled me for weeks before making the decision, answering honestly, and finally adding, “ believe me you really wouldn’t want to go into heart failure”! My ejection fraction at node ablation was 35%. Following node ablation it went immediately to 55%. At two years it was 70%. I am just 72. Hope this is helpful. Wish you all the best and good luck whatever your decision. Lee x

[Alphakiwi in reply to Lee-J]

Thanks for your comments Lee . I had pm implanted last wednesday with the object of having AV node ablation as i cant tolerate the tablets which dont do me any good. Since the pm went in i have had many hours of nasty palpitations all afternoon and in the night despite taking diltiazem as a pill in the pocket. I jusy cant hack it any longer . Today my wife and i walked to town and after a light lunch walked home. Palpotations started and that pain in tje upper back startef with a vengeance. Took ages to get home and kept going till 6pm ,then a huge double thump in the chest watching the tv news . The resulting headache from these lasts some time. Lying in bed now hoping the palps dont start again as it has been regularly when lyinging on my back especially. Gee hope i havent bored you but its one of my worst days and i was kinda hoping the pacemaker alone might do the trick. Its night time here in NZ.

[Lee-J in reply to Alphakiwi]

so sorry. Your response seems to have escaped me! How are you and, how did things go with the AV node ablation??

[Alphakiwi in reply to Lee-J]

Hi Lee-J, Its over a year now since pm implanted. Continued problems for the first few weeks which miraculously got less and less and so i took the diltiazemm less and less. The 5 week mark came and the surgeons decided not ablate and from there on i came right. I take no drugs but the blood thinner now and im fine except for the odd palp. This happened to CD Dreamer i believe. Long may it continue.I have the PM checked 6 monthly and last check showed it was operating 30% of the time ,which would be at night as it is set at kicking in when hr is below 60. At my firdt check at 1month the pm setting was changed from being effort sensitive to a fixed 60 bpm start.

[Hylda2 in reply to Alphakiwi]

had mine fitted last Tuesday. AF visiting daily mostly between 1pm and 2 pm oddly enough. Happy to ablate if necessary but would of course prefer not tod

[Alphakiwi in reply to Hylda2]

Wait and see. I went on to diltiazem as pill in pocket only and soon weened off completely. I have had the pill a couple times only in the kast year. Its there if i need it. The couple times i took it was hr at 80 at night which was uncomfortable. A couple of days onit and that was it.

[Hylda2 in reply to Alphakiwi]

🤞Noticed today I was actually in AF for hours before I even fell it which is looking good

[Lee-J]

That’s good news from both of you! Hang on to your natural pacemaker for as long as possible! Wish you both well. Lee