AV Node ablation & CRT Pacemaker - British Heart Fou...

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AV Node ablation & CRT Pacemaker


Hi I'm another newbie. I had a heart attack 20 years ago at the age of 55. It left me with atrial fibrillation and over the years I have been treated with medication, 2 pulmonary vein isolation ablations and 7 cardioversions. I don't seem to have many options left to me know and I have recently been diagnosed with heart failure Stage 2. My Cardiologist wants to ablate my AV node (the junction box in the heart), knock it out completely so only the heart muscle will work and insert a CRT pacemaker which I will be totally reliant on. This scares me! Obviously the Cardiologist is singing the praises of this procedure but I would really like to hear from anyone who has had this done to see how it affects them and what if any are the downsides of having it done. It is reversible, so there is no going back and I don't want at a later date to wish I hadn't had it done. I realise quality of life is better than quantity. No used getting to a great age if I can't do anything. My main problem is breathlessness mostly on exertion but also when just sitting doing nothing. I want to be up and away on my holidays, although I know I won't be able to do any until this pandemic is over. Does anyone have one of these pacemakers, they are not like the usual ones that a lot of people have when they have a slow heart beat, so I may not find anyone who can give me any advice. I am ever hopeful though. So if anyone out there can help me I would be very grateful.

6 Replies


My consultants have been wanting to do this on my heart for years. I have permanent AF, heart failure moderate and pulmonary hypertension

I suffer the same breathing problems, exhaustion etc etc

I have had 4 Ablations but nothing worked

I have a bi-ventricular pacemaker which has helped my bradycardia and also long sinus pauses

The pacemaker is the one if I go ahead with the AV node ablation

I will be on the same position again shortly when I see my consultants in August if the appointments go ahead

I also feel the same it is a final thing but I also Hopeful of new things coming as you know Heart Research goes in leaps and bounds

I am sorry I cannot day what you should do but wanted to let you know I am in the same place

Hi I was diagnosed with severe heart failure in 2018, I had a CRT-D implanted in 2019, it was suggested that I would benefit from an AV node ablation I investigated this and found it wasn’t reversible and it seemed wasn’t always successful so I decided I really didn’t want it done. In a recent Angiogram it showed my heart failure had gone from severe to mild to moderate so I know longer require the Ablation this I believe is thanks to the CRT-D I wonder if it would be possible for you to have the CRT first and see in time if there is such an improvement that you know longer require the Ablation


I can't talk from personal experience but the last time I was in the Heart Failure Clinic I was talking to a guy who was around 60 ish and he had been living for 5 years after having his AV node ablated and a CRT doing all the work. He was comfortable with it and his words, it was scary but not a lot of alternatives. He did say he had a decent Quality of Life. Currently a CRT is on the agenda for me and I would opt for that. I was discussing this with my Heart Nurse yesterday and she said it will be discussed at my next review. I do have a decent EF of 43% but am quite symptomatic !!

Hannah-Hay in reply to Prada47

Thanks for that. Sounds like the man you mention is like me with not many options left having had so many procedures done & trued so much medication. I find this site very useful everyone is so helpful. Best wishes.


I had a crt-d fitted in January 2020 and my heart failure has gone from severe to very mild if any according to my latest echo gram in February. So they are fabulous peices of equipment and you should seek it out. As for being pacemaker reliant, I’m not but not sure if I would want to be so I see what you mean. If the crt-d is going to supply the electrical part for the heart do you need to be ablated completely? Maybe something to ask the cardiologist, and don’t be worried if you want a second opinion. But since it’s fitting I’ve felt brilliant, getting better every week I think and only 5 months in, they did say it would take between 6-9 months to feel benefit but I felt better almost straight away. Also I’m on sacubitrol valsartan which is a big of a wonder drug too, so this combination has helped greatly.

I am a 73 year old female and only speaking for myself and we are all different but my story is ....

Last September, after two years of on/off misery and dramas I had an AV node ablation - I already had a CRT-pacemaker in place. I was naive and just accepted it as the only solution. And it has been wonderful! Within 48 hours I was back to being "me" again and since then life has continued to be so good and "normal"! So for me, it has been an unreservedly good thing and I am so grateful.

I wish you every possible success and good luck, whatever you decide.

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