AV Node Deterioration: I've had Permanent AF... - AF Association

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AV Node Deterioration


I've had Permanent AF for the past 4 years. I'm relatively symptom free and rate controlled but, last Friday, I fainted (syncope). I had a couple more episodes while in A&E. My heart actually stopped for nearly 20 seconds - not good.

I had a temporary pacemaker fitted the next day and a permanent one installed on Tuesday (Thanks to Yeovil District Hospital!). It prevents my heart rate from dropping too much. The pacemaker only cuts in if my heart rate drops below 60 - so most of the time it is just monitoring things.

The cardiologist said that, over time, the AV node becomes less reliable. Normally (i.e. for people not in AF), this isn't noticeable but, when in AF it is a bit critical. I'm not quite clear whether the deterioration is solely due to age or is a result of being in AF.

I've never heard of this previously, has anyone else?

11 Replies

Not able to help with your question Chris, but pleased to hear you are on the mend, it must have been a scary time for you. Have you moved further west? Best wishes, John

No, I was away camping for the weekend! :o

Wasn’t expecting that!!., All the best...👍

Not heard of this before. Sorry you have had such a scary experience but so pleased you now have a pacemaker to relieve the situation.

I can only guess that like the rest of our body as we age the AV node becomes less effective as does every other part of us. Just pleased they have got you sorted. Best wishes.

I hadn't heard of it either.

Is the deterioration worse if you are in permanent AF, I wonder?

I'm not sure. I think it is just more noticeable because, of course, you are relying on the AV node to pace your heart.

The article below might answer your question.

For people with tachybrady syndrome a pacemaker makes it possible to give medication for fast rhythms like AF/AFL, which would otherwise slow the heart too much.

As a matter of interest, what rate control med were you on when you fainted and what was the dose? What rate/rhythm meds are you on now?


I'm on 90mg of Diltiazem twice a day - which was working just fine. That hasn't changed. It was interesting that they stopped it for a few days while I was in hospital and my rate went up to c100 bpm even on minimal exercise (e.g. standing up).

Did the article answer your questions?

Not entirely but any additional information is always welcome - thanks.

Also called Sick Sinus Syndrome, I'm on the query list for a pacemaker because Diltiazem in higher doses slows my heart too much. I believe it's another bit of your body that just wears out with age 👵

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