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Hi Gloaming,
I always appreciate your input. It is obvious that you are extremely knowledgeable, even though - as you say - you are not a medical professional.
You mention RVR as being serious. I have had RVR with each episode of AFib - and I currently have RVR now. Hence, it is imperative that I stop my ventricle contractions.
However (unless I misunderstood you), I respectfully disagree with your statement that "there is no ablation, no lesions, when doing a pacemaker implant." If you are referring to just implanting the pacemaker, I - of course - agree with you. However, if you are referring to the procedure to destroy the AV node, I do not agree with you.
Ablation, by definition is a procedure doctors use to destroy abnormal tissue that can be present in many conditions. such as tumors in the lung, breast, thyroid, liver, spine, etc. Obviously, ablation is also used to destroy heart tissue that's causing irregular heartbeats.
My EP described two basic types of ablations - which he called an "AFib Ablation" or an "AV Node Ablation". The first ablation is, of course, the destruction of the many small lesions to prevent AFib. He (and another EP with whom I had a second opinion) felt that my chance of success with that ablation was very low. The other ablation is often called a "Pace and Ablate". I don't need the "pace" part because I had a pacemaker implanted 4 year ago. However, I will have the "ablate" portion, where he will ablate or destroy the Atrioventricular (AV) node, preventing the electrical heartbeat signal from my atria to my ventricles. The pacemaker will then "take over". I apologize if I misunderstood you, and your saying "there is no ablation" was only referring to a pacemaker implant, not the destruction of the AV Node. Thanks again for all your input; you have been very helpful to many of us.
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Yes, you describe it better than I did, Betty. I meant that, if no ablation is done, there won't be a disruption of signal, so there will be no change in arrhythmia above the AV node. As you say, if the node, itself, is ablated, then there can be no RVR because that response is precluded by the disruption of that pathway. Instead, the pacemaker takes over permanently, and it paces the rest of the heart's rhythm...or should if adjusted properly.
As you seem to have accepted, based on the opinions of two EPs now, your particular case is not likely to respond positively to a first/another atrial ablation. So, if that is the case, your condition above your left ventricle will not change, and may progress (as AF normally does). In my sloppy way, I was discussing the atrium and how a pacemaker installation, alone, will not change AF, and this is often the case, but you have correctly pointed out that another reader, including you, might think I was claiming that there is no ablation performed during a pacemaker implant. Naturally, that is not true...there MUST be an ablation to destroy the AV node. Otherwise, the two signaling bodies will merely fight each other.
Thanks for clearing that up.