AV Node ablation

[Borderterriorist]

I'm new to this forum so first of all, hello! I developed paroxysmal right sided atrial flutter in 2020, had a cardioversion in 2021 which worked well for two years. I have a stage one heart block but could only tolerate 1.25mg of bisoprolol without my HR dropping too low so I had a pacemaker fitted in May of this year and my dose increased to 5mg as I was having issues with flutter again. Unfortunately, whilst recovering from the pacemaker insertion I was admitted to A&E with a variety of arrhythmias which took 15 hours to settle. I had a pacemaker check a few weeks later and it was clear that I still had an unsafe arrhythmia despite being on 10mg of bisoprolol daily, dose changed to 7.5mg twice daily but I was still getting problems and tbh was feeling extremely tired and somewhat depressed! I saw my cardiology consultant last week and he's put me on the wait list for an AV Node ablation and changed my meds to digoxen + 5mg bisolprolol twice daily. Early days but I am feeling less tired and my resting HR is pretty settled, the pacemaker is keeping me at 61 bpm and I don't seem to be getting the chaotic rhythms that were pretty constant.

So, has anyone on the forum had an AV Node ablation to correct this sort of issue? I've always been very active and although nearly 76 I'd like to think that this procedure could be really helpful. Please share your experience if you have had this procedure. TIA

[Hidden]

I think you’re on the wrong forum. You need to post this on Atrial Fibrillation Support

Loads of people there have had pace and ablate and I don’t recollect anyone having negative experiences

And yes Digoxin is a first class drug as long as the prescriber knows what he’s doing.

Suggest ask for Digoxins levels.

[Borderterriorist in reply to Hidden]

Thanks for your reply, still finding my way around this site. Not sure what you mean by "digoxin levels".

[Hidden in reply to Borderterriorist]

Digoxin can be a highly toxic drug in the elderly and can, in the face of impaired renal function, accumulate with potentially disastrous consequences..

So you will need to have your “digoxin levels “ checked frequently, especially at the start of treatment and at 3 months intervals when the levels are stable. The sample required is taken 6 hours after the last dose.

Bear in mind also that you will need your potassium level checked at intervals if you are taking some diuretics, though this is not true digitoxin toxin.

[Borderterriorist]

Thanks I'll send a note to my GP as nothing has been flagged up for me.

[Twosumsmum]

hello

Just seen your old post .\

I had AV node ablation as I have flutter , and multiple other atrial arrhythmias. I have a 3 lead CRPT pacemaker and have found that I need the rate between 70 and 80 as otherwise the arrhythmias still cause problems even though I have had the ablation.

Also read you hare still sore following your pacemaker insertion, I takes months to get used to the thing , eventually it moves to a more comfy position, mine has a tendency to migrate under my arm on my chest wall . I did have a short time when it was very sore as it had rubbed and caused an ulcer they think under it , I used volterol cream ( diclofenic) with great success . I am only aware if the cat insists on sitting on it , or I had a fall flat on my face the banged it once . Ouch but no damage to packing or me .

[Borderterriorist in reply to Twosumsmum]

Thanks that's really helpful. I had the pacemaker initially for left bundle branch block and grade 1 heart block, if I took beta blockers my heart rate dropped too low but now they have suggested pace and ablate for my atypical atrial flutter. I think they consider it's safer for me to have an AV node ablation than a left sided ablation for the flutter which might not work anyway. My pacemaker is currently set at 60bpm but I'm on a very high dose of bisoprolol and also some digoxin and I'm hoping that I can come off the them or greatly reduce them if I have the ablation. I've got an echocardiogram on Monday to check my heart health generally and I'm hoping they don't find anything structural, it was OK in 2019. Are you able to do pretty much what you want now? I'm 76 soon, so don't want to run marathons but I do want to be able to walk the dog up a hill, which I'm fine doing some of the time but at other times I just can't without stopping and starting!