I V Node ablation

[nelly9]

This group is such a help .It was suggested awhile ago that I should have an I V node ablation .I do not know what is involved .Do I have a general or local .Do I stay as an inpatient ? How long does the procedure take .I was suddenly telephoned today with an appointment in 10 days time .Do I think about it for a while or go for it . ? Your advice so much appreciated .Thank you all .

[rosyG]

Very difficult fir people to advise without knowing your history and what’s been tried already. AV node ablation is a big step. See what some of the more experienced people say. I haven’t had the procedure. I hope it works out well fir you

[nelly9 in reply to rosyG]

Thank you for replying .Please see my reply to badger .

[CDreamer]

Pace & Ablate are 2 procedures. First a Pacemaker is implanted & adjusted to pace your heart in a way that suits you & is comfortable. The pacemaker is implanted under local anaesthetic & if you want it, sedation. It’s a day procedure.

After 6 weeks to check all is well, you have the second part - the AV node ablation. Catheter in the groin goes threaded through to the heart and the AV node is ablated in the same way as a PV ablation although its much quicker procedure - 45mins? You will have sedation for that. The AV node is your natural pacemaker so after that, you are Pacemaker dependant. You may need an overnight stay & you will need time to recover, as you would for PV ablation.

That means that you will no longer have an irregular pulse so you should be much less symptomatic. It seems to be a last resort for those of us for whom ablation & drugs failed to help. I have to say I felt MUCH better as soon as the PM was implanted although I had a few problems with the lead placement.

It’s a permanent, irreversible procedure so needs careful consideration but I couldn’t see myself continuing as I was. I was lucky in that the Pacemaker on its own worked for me so I cancelled the AV node ablation & to date no AF however if (or when) it returns I’ll go for the AV node ablation.

[ETFCfan in reply to CDreamer]

Thank you so much for your reply, I’m waiting to talk about this procedure too. I’ve read the information leaflet but always good to hear from someone with personal experience. Thanks again.

[nelly9 in reply to CDreamer]

Thank you for information about the Catheter and sedation as I had no idea .

[Hidden]

Hello Nelly9

This AFA fact sheet will help you

heartrhythmalliance.org/fil...

[Hidden]

If CDreamer’s excellent reply and the fact sheet give you some of the answers you are looking for, would it be a good idea to merge your two threads on the same topic, to avoid duplicate replies? If you would prefer to leave both in place, of course that’s absolutely fine, it’s just a suggestion.

[nelly9 in reply to Hidden]

Thank you .will look at fact sheet .

[nelly9 in reply to nelly9]

Yes merge the threads .Good idea .But how , as rather a lot of replies .

[playcards]

I had an ablate and pace in 2019 and have no regrets. Yes, it is irreversible and leaves you dependent on the pacemaker, but given the choice between trusting the pacemaker or trusting my unreliable and uncontrollable heart .........!

[nelly9 in reply to playcards]

Thank you for your help

[Barlick43]

I have had this ablation in 2017. Yes I am pacemaker dependant (scary)now and it is read regularly. I will need a new pacemaker by end of year as this is in since 2012. I have never had AF symptoms but the fear was that the af would set of tachycardia in the ventricles. So prevention of ventricular tachycardia was the purpose. I was con conscious but sedated ( aware and could just about see on monitor). They went in the groin vein, burnt off my the sinus cells of the node (the hearts natural pacemaker which was erratic) and It took about 30 -40 mins. I stayed in hospital observed four hours and then home. All ok

[nelly9 in reply to Barlick43]

Thank you so much for your reply . I am awaiting a telephone appointment that I have requested hoping for explanation .Preferably a Face to face one ? To suddenly get a phone call with message “ your operation for your heart will be on the 3 0 th “ .Out of the blue .I was referred to this Consultant 7 years ago and have never met him .I have been seen way back by Registrars and ended up 7 years ago with a pacemaker ,so still have that one and have regular annual checks .I am under the care of the G P but find it odd she does not get a copy of the p m report to decide on medication etc unless she asks .I do not have heart reviews with her either unless I ask .

The A V node ablation is booked for the 30 th I suddenly was told .The day before was given the 26 th for 2 nd covid jab and accepted .Is that time interval ok . ?

Thank you ALL for your replies .I feel totally lost .I have A F about every 6 weeks lasting 6 - 18 hours and it stops .On 2 occasions pulse v v high and B. P vv low . I can feel the A F starting and also stopping and then feel better .

Would the A V node ablation stop this happening ? Would symptoms be less ? If not what is the point of having it ? would it prevent other future problems .I am 78 and worked in the NHS for 50 years and should know the answers but I do not .I am vulnerable like everyone else .

Sorry to ramble on but I am SO GRATEFUL FOR ALL THE REPLIES .

THANK YOU ALL SO MUCH .

[Hidden in reply to nelly9]

Could you ask the arrhythmia nurse for advice, not least about your Covid vaccination date being so close to your procedure?

Your EP’s secretary can give you contact details. You could also email your EP explaining your very justified concern about the lack of information you have been given.

The AFA have a telephone number for advice, and the BHF have nurses you can contact.

[nelly9 in reply to Hidden]

Thank you B .I have asked if there is an arrhythmia nurse in the past and was told no .And I haven’t ever seen an EP . Only referred to this Consultant 7 years ago that I have never met , but saw v g Registrar at that time .Sadly he is a Consultant elsewhere now or I could talk to him . As I have said I have asked to see the Consultant that I have never met ,before the 30 th now or at worst a telephone appointment .I am not happy to go ahead with the AV ablation until I have talked to someone and received explanation .I think I have tried to be too good and not cause trouble over the years having worked in NHS but haven’t requested enough attention .7 years ago although the appointments with the registrar were good I had a great deal of pressure at every appointment to join research trials .I was already feeling shocked with sudden pacemaker ,and on warfarin without starting trials for research . I feel as vulnerable as I did then ,now . Thank you for listening .I won’t ramble any mor e.

[CDreamer in reply to nelly9]

Dear Nelly - I do think you need to be a little more assertive and I am rather shocked that you have had such poor preparation and left so uninformed. I understand you ‘don’t want to make trouble’ but in my experience with NHS specialist - she who asks the pertinent questions and doesn’t just accept all they are told - is more informed, receives better advice, is better prepared and therefore you can expect a better outcome.

It’s YOUR body, you need clear explanations and you need to see and speak to the specialist who will be performing the procedure - prior to the event! You would be wise to ask how many of these procedures they have performed, research where the person trained and who they trained with and ask what the outcomes of other patients were - it should be on record. If not, ask your GP to be referred elsewhere, that is you right.

Let’s be clear - you are allowing another person to thread a wire up through your veins, into your heart and burn cells within the heart. You want to do everything you can to ensure you know who will do the procedure and something about them. Although very rare, there are serious complications which you need to be aware of before you consent and you need time to process that information and help to decide if this is right for you.

Badger makes a good point - talk to someone from BHF or the AFA who will be able to explain things to you and help you consider how you might approach this but please don’t just accept what is offered without truly understanding what will happen and who will perform the procedure.

This is entirely my own view but comes from unfortunate experience when a cardiologist performed a procedure on my Pacemaker that I found out later he was not competent to perform and so I had to have a revision, very uncomfortable. They no longer work at that hospital and rightly so as my EP made sure of it as he had expressly requested that this particular cardiologist not perform the procedure on me.

[nelly9 in reply to CDreamer]

Thank you .Will follow your very good advice .