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AV Node Ablation with Pacemaker
My doctor is pushing for an AV Node Ablation with a Pacemaker. This is based on my heart rate being in the 40s or low 50s from medication to control Afib. I do occasionally go into Tachycardia Afib. My question is how successful is this procedure? I understand that I could still go into Afib tachycardia. Not sure I want to do this.
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People here who have recently had an AV node neutralization and a modern pacemaker say that they newest pacemakers will help with tachyarrhythmias by over-pacing. So I would ask that specific question: are there pacemakers that will double-cycle or whatever it's called to get a rapid HR back down to normal levels. I do know that in previous years, all pacemakers were meant to do is to speed up HR for those whose hearts beat too slowly.
As you must know, there is that real danger of a bad fall, hitting your head......we don't want to go there. So, this EP sounds like he has your best interests in mind. Even so, what would it cost you to get a second opinion?
@gloaming
Thank you so much for your response. Now I know another question to ask.
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1 Reaction@nanalu
Hello! I completely understand your hesitation for an AV Node Ablation. My EP was "pushing" for that for me for months; I was very reluctant - but finally did agree. I had the procedure last August, 8 months ago. The procedure is very successful and very quick (as far as ablations go). As you know, it "burns the bridge" (the AV Node) between the atria and the ventricles. The pacemaker controls the heart rhythm in your ventricles, so your pulse will be regular, according to the settings on the pacemaker.
I just had my pacemaker adjusted because I was getting so short of breath while exercising. They adjusted the response rate. He explained that if I was trying to climb a hill, and my heart rate was staying at 60, I would be short of breath working so hard. Letting my heart rate increase for exercise made a difference. Keep in mind that a pacemaker can be "tweaked" often; very few of us can live with the 'default' settings!
Your second question... YES, you can still go into AFIB. However, it will not affect your heart rate, because they "burned the bridge". That was also a big concern of mine. I did go into AFIB, and I was alerted by the Pacemaker clinic. According to my Apple Watch and my KardiaMobile, I am NOT in AFIB (I believe those devices key off the pulse rate). According to my EP, my shortness of breath has nothing to do with being in AFIB. Since I am also dealing with lung toxicity (from Amiodarone) and diastolic dysfunction, I have multiple potential causes.
Looking back (although I fought it for months), I am glad I had the procedure. NONE of the meds worked for me, and I was frequently in AFIB with RVR. I am now able to stop all the Antiarrhythmic meds!! Good luck! Let me know what you decide.
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1 Reaction@bettycll Thanks for your affirmation and sharing, Betty.
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1 Reaction@nanalu
Can speak from experience on ventricles on ablations. Probably 10 years ago had ablation on RV and it worked.
I am having a ton of PVCs and on off tachycardias. The amiodarone keeps the tachycardia down but still goes up to 140+. I was and still taking Mexiletine for PVCs but they steadily got worse.
I have ablation on June 2026 on LV to correct thousands of PVCs each day which I think is causing he VTAC.