av node ablation for IST

I know that many of you had AV node ablation for atrial fibrillation. In my case, I don't have that, but inappropriate sinus tachycardia. I've had 6 ablations (including 2 SA node modifications and 1 complete SA node ablation with implantation of a pacemaker). Nothing helped. My EP now suggested AV node ablation. My other EPs told me that it could cause asynchrony and that it wasn't a good choice for someone my age (I'm 27). But this new EP says that he can avoid that with what I believe is resynchronization therapy (he said that he would change my pacemaker for another one that could use three wires and that with the third wire in the left ventricle he could avoid this problem). I want to know if someone had this done for this condition and if it worked. I also want to ask if the pacemaker is much bigger than then traditional bipolar one. I'm really tiny and my incision is really short and slim but I think this new PM won't fit there. Just wondering...

Thanks,
Meredith

4 Comments

not sure

by nat36 - 2010-10-25 03:10:49

I have not had an AV node ablation but I did have a sinus node modification and pacemaker. I had SSS and IST. I still have atrial tach a lot and can not seem to find relief. My doctor will not do the AV node ablation either. I am 38 so not near as young as you but dealing with a similiar issue. I am on sotalol which helps but not completely. Some days are worse than others and I feel like the doctor is saying you just have to live with it at this point. So if you get some answers please share. Good luck with whatever you decide. If it was me I would have to go with whatever doctor I had the most confidence in.

split decision

by sam78 - 2010-10-25 10:10:35

I have both atrial tach (from a focal point near the SA node) and IST. I had my AV node completely ablated and of course pacemaker dependant. I personally have had just as much problems with symptoms now as I did prior to have this done. I am also on the same medications as I was on prior to getting the pacemaker (an extremely frustrating point for me as that is what made me decide to do this). I had an absolute horrendous time in the beginning with asynchrony. For me they set my upper rate fairly low (only 120) so that when the a-tach or IST kicked in it would not conduct. However that would make be beat totally out of synch since my top chamber was beating twice a fast as the lower chamber. It felt almost as bad, if not worse than the IST did. I have had my pacemaker for a year and a half and we still struggle to get settings right. We have put me into a mode switch so that it switches to a different mode when it goes about 135 which has helped with the feelings that the asynchrony causes, but does not eliminate it. We have never talked about putting a third wire in, so I have no idea what that would do. However, given my experience, I would be hard pressed to recommend the AV node ablation, as for me, it really hasnt done much good. Purely my opinion though.

also

by sam78 - 2010-10-25 10:10:46

sorry forgot to add that I am only 32.

so far, so good

by mereiriz - 2011-03-09 10:03:12

I just wanted to tell you that I had my AV node ablation on Feb 25 and so far I'm feeling great! No more arrhythmias and no problems with asynchrony. The third lead they implanted on the left side is really helping!

Meredith

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