AV Node Ablation

I am 35 years old. I had open heart surger for atrial septal defect repair when I was 5. I was fine until 2006. Then I passed out and found out that I had bradycardia of 20 to 30 bpm. So I got a normal pacemaker implanted. I have since had 6 ablations for tachycardia and my pacemakers leads are not working properly. All of my ablations were a failure. None of them seemed to help my atrial tachycaridas. Now I went in for another check up and my doctor wants to extract my leads, put in a biventricular pacemaker, and ablate my av node. I am wondering if anyone can help me decide if this is the right thing to do. I need so advice. Medication doesn't help and the 6 ablations I have had were unsuccessful. Please if anyone could give me their opinon and stories maybe I can make the right decision. My quality of life is really bad. I can't even do simple house work, it tires me out. I also was wondering about if your heart is 100% paced, does that bring down the quantity of your life. I guess I would rather have quality over quantity. Does the av node ablation cause these tachycardias to go away, or does it just mask the problem.
Thank you so much for any help anyone can give me.
Twila

5 Comments

Thank You

by Twylight - 2010-03-09 03:03:09

Thank you for your advice. I have to ask my doctor quite a few questions. I am so sorry to hear about your heart problems as well. It helps to know that there are other people in the same situation. Not that I would wish these problems on my worse enemy. I hope you get your heart health under control. I don't know if I ever will. I just want to be able to walk around without getting so dizzy and winded all the time. My heart feels like it is trying to beat out of my chest. Maybe what my first step to do is get those leads extracted and then get a biventricular pacemaker and see if that works first. If it doesn't than maybe I will have to do the AV Node ablation. I don't want to do anything that is final too quick. What did they say about your heart being 100 percent paced? Does that weaken your heart faster? Just wondering. Thanks again for your insight into my dilema.
Twila

Sorry

by Angelie - 2010-03-09 03:03:16

Sorry you're having a rough time. We're about the same age, and I as well have had 6 ablations for atrial tachycardia.
The AV node ablation will just mask the problem. Your atria might still continue with it's fast rhythms but the signal will not make it down the electrical line. It's very difficult to stop fast rhythms. Luckily after so many ablations, or possibly just a natural progression of my sick sinus syndrome- my sinus node just up and died one day. I'm now 100% atrial paced, but I've got great conduction on the lower end. My heart just doesn't initiate a beat, but at least it's not fast anymore. Actually my AV node will start being my pacemaker if for some reason something goes wrong with my artificial pacemaker, or something goes wrong with my leads. This escape rhythm doesn't sustain me very well, but at least I know my heart will beat some until I can get to a hospital. After so many failed ablations, I begged my doctor to ablate my AV node after he mentioned it to me as an option. Later, he convinced me to try one more ablation where he discovered that my AV node was not the problem and it was working perfectly well. I was disappointed at the time, but it turned out to be one of the greatest decisions. I mean, why kill something that's working completely fine?
He re-arranged my atrial lead so it would get a better signal which turned out to make all the difference in the world.
Make sure you understand your doctor's reasons for wanting to ablate your AV node. In your case, it might be the best option for you. Just know and make sure you understand your condition.

Best of luck,
Angelie

same situation

by sam78 - 2010-03-09 05:03:51

Hi Twila. I was in the same situation. I had atrial tachycardias that couldnt be ablated and were not controlled with meds. I was passing out, couldnt exert myself at all. All horribly annoying. First thing that my EP did was implant a holter monitor to record everything. Once he realized how much inappropriate tachycardia I was having he scheduled me for my pacemaker. I had a pacemaker implanted and then 6 weeks later (after the leads had healed in place well) ablated my AV node. This happened to me last June. It has been both helpful and not. I have still had to continue on the same heart medication because while the atrial tachycardia does not conduct to the ventricles, it still does race and makes me feel horrible. Yes I have not passed out any more. Yes I am a little bit more activity tolerant. Trying to get the settings appropriate has been very challenging. I am of course now paced 100% in the ventricles. Very long term, yes it does weaken your heart, but it is very long term and it is because it forces the heart to beat a bit different then it normally does. But on the other hand, having long term tachycardia will wear your heart out just as much so really it is a mute point. I know exactly where you are at in your situation. You feel miserable now, and this is big decision. Yes on paper it will "cure" your atrial tachycardia because it wont be able to conduct. But then on the other hand, you have to deal with pacemaker issues (lead changes, battery changes, setting changes). Some people get it done and are cured and are very thankful. Some people get it done and wish they wouldnt have. It is something you will have to decide for yourself... have to decide your quality of life for yourself right now. Good luck. We are here to help ya with questions. There are many of us that have had AV node ablations.

AV Node Ablation!

by Seniorcitizen - 2010-03-10 02:03:05

first I had 3 ablations and all were unsuccesival. I kept having to be cardio verted to get my heart to beat properly. Then finally they did an AV node ablation and I have had this one for over a year and a half....It has 3 leads. Big as a pack of cigarettes or a little radio. You can see it no matter what I wear.Good luck to you all. Would love to hear from you all.

Node Ablations

by sdwalker - 2010-03-12 12:03:52

In 2001 I had both nodes in my heart ablated and I've been life dependent on the dual chamber permanent pacemaker ever since. I was age 51 at the time and my quality of life was poor. I have been greatly improved. I enjoy a good quality of life and remain busy most of the time. My diagnosis was Ebstein Anomaly. I have no doubt this procedure saved my life. I pray that you'll have the best of care possible to meet your needs.

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So, my advice is to go about your daily routine and forget that you have a pacemaker implanted in your body.