Av-node ablation

Yes I know this is a big deal. I am wondering who has had them.. what they have experienced. I have a long cardiac history. And afib wise I have had 2 ablations. First one for afib and then a few months later for flutter. That was 4 years ago. Was doing well until life got really difficult this year. Flutter and fib and cardioverison but I'm in and out and signed up for an ablation. My 3 cardiologists (including an EP) say the flutter is EZ but the fib is not. But what about AV-Node? I know the atria part of the heart will still be fibbing away. Im not sure what the means for heart failure ?? I know fib isn't great for it... and also thinking continual ablations isn't great for the heart failure either (HFpEF... preserved ejection fraction). I was a pest and I have an appointment on Monday with the NP in the EP group to discuss all this. I was also told that an AV node ablation isn't the easiest given my anatomy. I know only the docs can really chime in on this for me but wondering peoples experience. I realize I would be pace maker dependent for life (I'm just shy of 60). But in my reading this might really help if we can't get the fib under control.

susan.d had one. Here is a search on her posts on the topic [www.afibbers.org]

Have not had one, but I have read many posts by those who had little other recourse over seemingly intractable rhythm problems of one kind or another. They invariably come back and report that they have their lives back and are grateful.

One buzzing fly in the ointment, though: an AV node nuke and ICD/pacemaker installation doesn't guarantee a correction to all AF cases. Sometimes it works, and you would be a fully grateful and relaxed wearer of a pacemaker. For others, the AF continues, but at least they don't also have RVR and so many symptoms.

Was AV Node ablation recommended and why? Because it not, it seems like you jumping too far ahead after only one failed AF ablation. It often takes more than one ablation to get it right.

Without knowing your EP, hard to comment, but I'm a big fan of second and perhaps even more opinions (I had five) especially in hard to treat cases, which your cardiologist's inferred. And ideally they should be at a top ten or top 15 cardiac hospital that does high-volume ablations. Those centers see more, know more, and have better results.

Jim

My understandiung is that AV node ablation disconnects the atria signals from the ventricles. Hence the ventricles are not subect to the potential high rates and irregular beats that the atria in fibrillation can present. It does not stop the atria from fibrillating or fluttering, or any stroke risk that goes with the fib or flutter. You are then pretty dependent on a pacemaker. Susan has experienced issues with side effects from atrial rhythms subsequent to her AV node ablation.

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GeorgeN
susan.d had one. Here is a search on her posts on the topic [www.afibbers.org]

It’s saved my life. No more tachycardia flutters

It’s the last resort. Make sure you exhausted all other options. I wouldn’t worry about pacing induced cardiomyopathy. You can always get a third lead (2 V, 1 atrium) new pacemaker. I just keep an eye on my EF. I used to go to the ER 26 days of a month and hospitalized while they failed to convert me. Now I have a steady 70hr. My battery will last 5 more years.

Yes you will feel your afib but it’s now not as dangerous because your ventricles are controlled. In fact, you can get pacemaker boost therapy programmed and for me my PM converts 25-27% of my afib/VT/AT.

It’s a permanent nuke ablation. Make sure you ran out of options before having it done.

Thanks all. Yea I did a lot of research today on open evidence AI. (my EP NP actually recommended it as doctors us it.) I put in my other conditions and ... well.. the AV node ablation can get complicated for me. I know they will try a regular one first. And my last ones I would deem a success. Tomorrow we discuss meds, ablations etc. Mostly I used AI to gear me with a lot of questions which I also am taking info from here. Thanks again folks.

I am going to Cleveland for HFpEF (preserved ejection fraction) in August. I don't want to wait until then for an ablation if I can help it. And you can't get into an EP at Cleveland until another cardioglost recommends you. I may be able to have my functional cardioglost take a stab at that appointment.

Have you had a recent cardiac MRI? It provides an accurate EF as long as you are in NSR.

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susan.d
Have you had a recent cardiac MRI? It provides an accurate EF as long as you are in NSR.

My diagnosis is HFpEF.. so HF with preserved ejection fraction. (about 50% of HFis this type)