AV Node Ablation - info on Pace and Ablate.

[Cupani]

I have just joined as wanting to find out if anyone has personal experience of the AV Node Ablation for AF. Had a dual chamber pacemaker fitted last month and go for the Ablation in May. Hoping to get some advice, tips or guidance from members who have gone through this process. Feeling nervous as there is no going back once the AV Node has been ablated but feeling unwell and more or less housebound so something has to be done!

[TheStand]

Cupani,

If you don't mind me asking... Why did they put in the pacemaker in the first place? Was there a history of heart issues?

Tim

[Cupani]

Thanks Tim for your reply. Started with high bp followed by AF about 10 years ago, which got progressively worse. My father and grandfather both had heart problems so I think the answer is yes to your second question.

The EP offered both catheter ablation and also AV Node Ablation. The first seemed a longer, painful and possibly less successful procedure. The second less dangerous and more successful, but I am beginning to wonder. I've read the AF sheet on AV Node Ablation plus the AF surgical ablation booklet and other docs/booklets but now trying to find someone who has actually had an AV Node Ablation.

The heart rate was consistently high pre-pacemaker. It is not yet fully connected due to it still being high post op, One lead has been set but they were unable to connect the second lead. Having first check-up this week so maybe it will be resolved. I'm on high doses of meds, verapamil especially, digoxin, diuretic, warfarin, and statin for sympton control until procedure but less than comfortable.

I believe the object of a pacemaker is for it to take over the heart beats once the AV Node has been severed at Ablation.

I hope this makes sense! Really appreciate all knowledge and assistance.

Cupani

[Beancounter Volunteer]

Hi Cuprani,

I am by no means an expert on this, but my understanding is that node ablation is usually an ablation of last resort, usually after the catheter ablation has been tried first.

I understand that once the AV node is cauterized it will never be able to regulate the heart and the pacemaker will need to be present at all times.

Obviously we don't know all of your medical history other than what you have shared, and I have not had either type of ablation so can't comment from personal experience, but I think I would try a catheter ablation first, in my circumstances anyway. All the reports from those who have had it seem certainly not to report more painful, longer maybe, not the operation, but the chance of a necessary repeat, and less successful?, depends how you measure success; many have had catheter ablations and then remained symptom free for a very long time, in my opinion that is a success over and above being on a pacemaker permanently.

I think you are doing exactly the right thing by asking more questions, and I certainly wish you all the best

Ian