When is AV Node ablation the answer?

I have permanent AF. An attempt at ablation failed because my right atrium is enlarged and it was not possible to get a catheter through the OS from the right atrium and into the left. My EP initially suggested an AV node ablation but then, without telling me the reason decided not to, saying that it would not stop the AF. I am now left rather confused as to whether or not AV node ablation would help me.

[BobD Volunteer]

Pace and ablate does not stop AF which happens spontaneously in the left atrium.

Whilst it may improve quality of life by ensuring a steady ventricular rate the fibrillation may still continue and be felt. As such you may feel better and have more strength but if the bag of worms upsets you this will continue.

[CDreamer]

Good question - my answer - when all else has failed and you are still symptomatic. As Bob says it won’t stop the AF - that is not the point of the procedure - the point is to improve QOL. If you are not symptomatic I wouldn’t. Did you ask your EP why he changed his mind?

I am on waiting list.

[Hidden in reply to CDreamer]

I'm not sure what you mean about being, or not being, symptomatic. I get very breathless on occasions when walking or climbing stairs, and feel very tired most of the time.

[CDreamer in reply to Hidden]

Then that is symptomatic and I think the stats are that something like 70% of people with Pace & Ablate find an improvement in symptoms ie less breathless, less tired but they still have and feel AF.

[mjames1]

I would ask the ep why. Also, was your ep talking about pace and ablate or simply an SVT ablation near the AV node. Some studies suggest an SVT ablationcan help afib if the trigger is AVNRT which is common SVT.

Jim