Heat versus Cold Ablation

[www.ohio.com]

They mention the danger of requiring a pacemaker with RF ablation in this articel about cryo vs RF ablation. I have never heard of anyone that I can recall saying they needed a pacemaker because of an erroneous RF burn. I would like to know the percentage of patients that this happens to.

Does anyone know if this has happened? Could someone who is seeing Dr. Natale in the near future ask him how many of his RF ablation patients (and there has been many-600 plus I believe) has ended up with a pacemaker due to an erroneous RF burn during their afib ablation procedure?

Keith

fib:
I don't think it's a risk for PVA ablations. I believe, not looking back, that it was a 21 y.o. who probably had SVT and an accessory pathway rather than afib and requiring a PVA. The article said that he was ablating very near the AV node. I think it must have been a linear ablation of a pathway. I have never heard of PVA with accidental ablation of the AV node. Of course I had never heard of destroying a persons Mitral Valve during a PVA ablation either. So who knows. Just my guess.

Pam

When I was talking to Minerva in Dr. Natale's office last week about sending them my medical records to be evaluated for an ablation procedure I specifically asked about the possibility of needing a pacemaker after the procedure. She indicated to me that they try never to get involved with a pacemaker unless it is absolutely necessary.

Howie,

I understand that Natale would try to avoid a pacemaker. Sometimes people get pacemakers to help alleviate their afib. This is intentional. The question I am asking is did Natale ever make an erroneous RF burn damaging the AV or SA node which resulted in the need for a pacemaker.

Personally I think it is very rare and I have never heard of it but I guess it could happen.


Description:

AV node: The AV node (AV stands for atrioventricular) is an electrical relay station between the atria (the upper) and the ventricles (the lower chambers of the heart). Electrical signals from the atria must pass through the AV node to reach the ventricles.

The AV node is one of the major elements in the cardiac conduction system, the system that controls the heart rate. This stunningly designed system generates electrical impulses and conducts them throughout the muscle of the heart, stimulating the heart to contract and pump blood.

The SA node (SA stands for sinoatrial) is the heart's natural pacemaker. The SA node consists of a cluster of cells that are situated in the upper part of the wall of the right atrium (the right upper chamber of the heart). The electrical impulses are generated there. The SA node is also called the sinus node.

The electrical signal generated by the SA node moves from cell to cell down through the heart until it reaches the AV node, a cluster of cells situated in the center of the heart between the atria and ventricles. The AV node serves as a gate (an "electrical relay station") that slows the electrical current before the signal is permitted to pass down through to the ventricles. This delay ensures that the atria have a chance to fully contract before the ventricles are stimulated. After passing the AV node, the electrical current travels to the ventricles along special fibers embedded in the walls of the lower part of the heart.

Fib,
I understand your question, I just don't know the answer.

thanks for the info Pam