pace and ablate

feeling a little lost and confused, saw my EP yesterday after having two previous ablations for paf and tachycardia, my alivcor shows that I am in af most days with a hr of EP has given me two options to think about one is a further ablation but to be done under general anesthetic (they had problems with sedation on the last one) or to have pace and ablate, he seems to prefer the pace and ablate option as it should mean that I can come off some of the medication, Bisoprolol and Dronedarone. But to me the pace and ablate seems so final to be left totally dependant on a pacemaker, has anyone on here recently been given this decision to make? please would love to hear from you.

13 Replies

  • Sorry I don't know much about it but if you type in pace and ablate in the search box top right of page something should come up .

  • Popular subject it seems several posts about P an A recently.

  • I saw an EP privately recently. He has advised me of both options. I have never had an ablation and he has some concern as to its success or effectiveness in my case because an MRI scan has thrown up a past myocardial infarction,about which I have no knowledge or recollection. ''''Tis a mystery. He has not ruled out a pace and ablate, but like you I am not keen on the implied dependency on a machine.

  • I've had the AV Node Ablation after having two RF Ablations which only lasted twelve months each. One Cardioversion. The AF became too powerful for the meds so the last resort was the AVNA.

    It was the best thing ever for me to happen. I have my life back, I can breathe and exercise again. No Antiarythmic drugs with side effects.

    I had the pacemaker 4 years before the Ablation so that was no big deal.

    I can only say for me that was the best thing ever to happen in this journey with AF.



  • I haven't had pace and ablate but for other reasons have a pacemaker. Meds and it have given me a new lease of life gym5/6 days a week five mile walk today.

  • I am considering it also and have just taken advice from several people and for me it does look like a good long term and viable option - drugs are not an option for me long term - ablation is a risk with uncertain outcomes so I intend to research a lot further and would advise you to do likewise.

    I think it is becoming a more viable alternative to multiple ablations or long term drug therapy but I think we need to be well informed before taking that irreversible very big step.

  • If/when I go back into AF then P and A wold be the option for me after 4 ablations. My EP would not consider it before as I am too young ( 64!)

  • Pace & ablate has been discussed for me.

    In my case I have similar reservations to others because of the total reliance on a mechanical device. In addition, in my case, I am scared to have an implant due to my preponderance to allergic reactions following procedures for my heart.

    A doctor has told me that sometimes they can implant a pacemaker to resolve AF without ablating the AV Node.

    I also understand that they can implant the pacemaker and do the AV node ablation about 6 weeks later once they are satisfied that the pacemaker is effective.


  • Can a pacemaker resolve AF? Previous postings here have said not. All mine does is speed my heart rate up when it goes under 60bpm and stop the pauses..

  • I too am going down this route. Pacemaker fitted 18 months ago and so far only 1 AF event since the 3 lead Pacemaker fitted so have delayed the node ablation until I have further problems . My only concern is QOL afterwards not the reliance on the PM my natural PM is pretty shot anyway!!

    Good luck and stay well.

  • I too am in this position of pace and ablate being the only option for me too as have had all the Meds and none work well enough and 3 ablations the longest lasting was 5 months. I am sitting on the fence too at the moment as afraid they will find a cure as soon as I have had it done and it is irreversible. I am also reluctant to rely on an electrical device to keep me alive. Although I am in persistent AF at the moment with rhythm changing hourly from slow AF to tachycardia up to 130 I am trying to train my mind to ignore it, not doing great but getting on with my life at the moment. Read all you can, some sites are impossible because of terminology but there are loads out there, read, read and read some more. Good luck.


  • Brenda

    You echo my feelings exactly.

    It is all getting very scary.


  • Thanks for all your kind replies and words of advice, it's nice to know that others in the same situation have some doubts as to which route to go down, have a little more time before I have to make a decision so will do a bit more research on the options. Thankyou

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