AV Node ablation

[nelly9]

I am due to have an I V node ablation and do not really understand what is involved and the reasons to choose to do it .

[pottypete1]

The AV node transmits the electrical impulses that cause the heart to beat.

It has been offered to me but for reasons to do with allergies I am not pursuing this option yet.

To ablate the AV node my understanding is that normally a pacemaker is implanted first. The efficiency of the pacemaker is monitored for some weeks before proceeding to an ablation of the AV node. This is known as pace & abate.

I know of at least one regular on this forum who has received sufficient benefit from the pacemaker to assure her that the first step was sufficient.

I must say I have never heard of just AV node ablation as the pacemaker is necessary to enable the heart to be assisted to beat effectively.

I suggest you contact your EP again and obtain a full explanation of what is planned for you.

Pete

[Palpman]

A short explanation;

The hearts natural pacemaker is the Sinus Node above the right atria.

This signal pulses the atrials and travels down to the Atrial Ventrial Node or AV Node.

This is between the right atrium and right ventricle and this node acts as the traffic officer.

It stops the signal for a brief period known as the refractory period. Nothing can happen during this pause.

This is to synchronise the beats between the atrials and ventricles so they don't beat simultaneously.

It also protects the ventricles from rapid atrial arrhythmias.

When the refractory period times out (100ms) then the node allows the signal to pass down to both ventricles to pulse them.

If you have a heartblock or bundle branch block where the signal does not always go past this node then you have "missed" beats or a very slow heartbeat.

Anomalous fast signals on rare occasions do pass and cause dangerous ventricular arrhythmias.

The caurterization of the AV Node prevents any signal from the atria to pass to the ventricles.

If this ablation is done then a pacemaker is required to pulse the ventricles.

The pacemaker is placed before the ablation to ensure it's proper operation.

I hope this helps with your understanding of requirement of the pace and ablate procedure.

[Visacrem in reply to Palpman]

Thank you for that brief description Palpman, it's exactly what I was looking for as I'm on day one recovering from an unrelated operation that nearly got cancelled due to the fact that an ECG during my pre op found I had stage 1 heart block which made my anxiety levels hit the roof. I need to contact my GP and get it looked into. Found your description easy to understand thanks again.

[Palpman in reply to Visacrem]

Many of us have stage 1 heartblock but it is benign and often needs no treatment. Mine leads to bradycardia and at times to stage 2 or Mobitz type 2 where it goes so slow it skips a beat.

[Visacrem in reply to Palpman]

Thanks again for that. I've not been able to see a cardiologist other than a phone consultation which was useless since my diagnosis last August, they put me on beta blockers Abiscopan and bisoprolol anticoagulant, but the problem was that my heart rate is down to 42 beats, I stopped taking both tablets before my operation but don't want to start up the beta blockers until I've seen my GP, what's your experience please do you take the beta blockers when you're in bradycardia.

[Palpman in reply to Visacrem]

My HB went down to 43 so I stopped my bb myself as I knew my GP would have done so.

[Palpman]

I must add to my long post:

The pace and ablate procedure exises the AV Node so no signals can pass from the atria to the ventricles.

The Sinus Node will still carry on as normal or abnormal but has no effect on the ventricles.

The Atrials can flutter or fibrliate and blood will still gravitate into the ventricles. Pumping of blood into the ventricles is not required to be forceful.

The ventricles have to pump blood throughout the body and back to the Atrials. The pacemaker will pulse the ventricles but not the atrials.

Only if both nodes are cauterized will the pacemaker pulse both.

I am done now thanks for reading.

[TracyAdmin Partner]

Hello nelly9, if you would like some advice or information regarding the procedure, please feel free to visit our AFA website heartrhythmalliance.org/afa... for our Patient Resources or and join our 'Virtual Patient Educational Platform' for video presentations on a range of topics, or alternatively, please contact Patient Services [e-mail]