August 23, 2017

AV Node Ablation: Why You Shouldn’t Have It

One topic, AV node ablation, makes the rounds of the atrial fibrillation discussion groups on a regular basis, and has just come back around again. All at about the same time, several afib patients’ doctors have insisted that they have an AV node ablation with a pacemaker implant. Thus they have come seeking others’ experiences.

In this procedure, the AV (atrio-ventricular) node is frozen or cauterized to stop electrical signals from being transmitted from the upper chambers, the atria, to the lower chambers, the ventricles, and a permanent pacemaker is implanted to control the heart’s electrical system.

Supposedly, at least according to some doctors, the AV node ablation will eliminate afib, or at least patients won’t feel it any more. Wrong, say many who have had the procedure. They still feel it, and they are just as miserable.

And whether or not you feel your afib, it’s still damaging your heart, and you’re still at risk of blood clots and strokes. Thus you’ll probably still be on anticoagulants, such as Coumadinâ or warfarin.

I don’t have anything against pacemakers – they do a great job of keeping people alive and of detecting irregularities. We’re lucky to have this technology.

But please, please, just don’t sever that AV node that connects the atria to the ventricles. It’s so FINAL. You probably won’t be able to take advantage of advances in medical technology, and if there’s a problem with your pacemaker, you darn sure better be able to get to an emergency room quickly.

So, lets see…

  • you’ll still have afib
  • you’ll still be at risk of strokes
  • you’ll probably still be on Coumadinâ
  • you’ll be pacemaker-dependant
  • you may not be able to take advantage of advances in medical technology

Now, why is it you would WANT an AV node ablation? Duh!

This controversy seems to be pitting patients against their doctors. One mentioned that her doctor thought she was obstinate for not wanting an AV node ablation. She’s not being obstinate. It’s her body, and she gets to make the decisions. She doesn’t want one, and considers the procedure prehistoric. She’s right!

Maybe for some patients it’s the only answer. But I suspect that applies to far fewer patients than actually get the procedure. Is this just another case of Clueless Doctors who are just not aware of what afib does to us? Or are these doctors unaware of all the other Options Available? Or is it an economic decision? I sure hope not. Is it naïve to still believe that doctors want the best for their patients and will help them find a cure?

What has been your experience regarding AV node ablation? You’re welcome to join our discussion or share your thoughts and comments below. Thanks.

Comments

  1. I’m a 79 year old Scottish male living in South Africa and have suffered from A/F probably for at least 10 years but my GP at that time missed it. I’ve had shock treatment twice, the second attempt lasted about 6 months then the A/F returned. As none of the drugs appeared the be successful (I’m also lactose intolertant and suffer from COPD thanks to my doctors as accuhalers contain Lactose based power which they never knew about or checked),
    My new Cardiologist suggested a Pacemaker with the option of an AV node ablation. As a retired Engineer I tend not to fully trust devices from which there is no return. Currently I’m on Adco Zildem + warfarin. My lower legs and feet swell due to this drug and so a “water tablet” was tried but that lowered my blood pressure so much that I took dizzy turns. I’ve now been given the alternative by my Cardiologist have the AV node Ablation, or put up with the dramatic swelling of my lower legs and feet which limits my exercise capability to help my lungs cope with the COPD.

    What is the answer????

    • Brenna Lara says:

      Hi Norman,

      Thank you for sharing your afib story and what you have done so far to manage your afib. We don’t know much about what treatments are available to you in South Africa. Here in the US, age 80 is typically the cut-off for catheter ablation and often for afib surgery (maze and mini-maze), too. It may be that those options are not available to you, and thus may be that the AV node ablation is your best option now. You may be interested in joining our patient discussion forum (http://forum.stopafib.org/index.php) to connect with other patients who collectively have a great amount of knowledge and experience. You may want to post your story and experience there, and you may also learn a lot from others who have already shared their experience.

      You’ll need to join to see and participate in the discussion. To do so, go to forum.stopafib.org, and click on the big red button that says, “Sign Up”. Once you sign up by registering your email address, your preferred username, and a password, you’ll receive an email to confirm your interest in joining the forum. Click on the confirmation link in that email, and you are ready to go. You’ll be able to log into the forum, read the discussions, and participate. I hope that you are able to find others to connect with there that can give you advice, suggestions, and hope.

      You can view a how-to video here: http://getinrhythm.com/how-to-register-on-forum

      There are many resources on living with afib that you might find helpful. For more information on afib and afib management, we have many resources available to you.
      • News Stories on afib http://www.stopafib.org/news.cfm
      • Patient Resources at MyAfibExperience.org
      • Afib Blog
      • Video Presentations from the 2015 Atrial Fibrillation Patient Event

      Best of luck to you! We wish you sinus rhythm.

  2. David Corran says:

    I have had irregular heartbeat off and on for about 10 years. The first time electro version was used and it lasted about three years. The second time electro version was used it lasted about a year. The third time the conversion did not work and I woke up still suffering from the out of rhythm condition. Then full heart ablation was recommended and performed. I was under for about six hours, and really the effects of the surgery were harder than the ablation. The bruising was intense, the catheter was a nuisance, for 24 hours, and the incisions hurt for several weeks, There were three incisions one in my neck. I hate hospitals and it is a joke to me that they expect you to rest in Grand Central Station. it took several weeks to feel good, I was still run down but the doctor explained that since many nerves were ablated that parts of my heart were not functioning as normal and it would get better. It did for about 11 months. Them I woke up one day out of rhythm ( not literally one day but over a period I started feeling run down, no energy, no reserve, no stamina. Now the same doctor is recommending a pace maker with an AV node ablation, Together, same day. He said the pace maker can’t correct and maintain the hearts rhythm without disconnecting the false signals coming from the upper heart. He makes the procedure sound very simple, by today’s standards, local anesthesia, minimal invasion, slight risk of side effects or trouble ( he mentioned only infection ) but it sounds to simple and NO catheter. I am troubled that it sounds too simple but it is certainly too final, too absolute, I know I can’t live anywhere close to a normal life as is. I have no energy. no reserve, nothing long term. The slightest activities like a shower and getting dressed and especially putting on socks and shoes and I am drained, huffing like a freight train and ready to lay down I take, or want to take a lot of naps. BTW I do wear a C-PAP, always, never miss not even for a short nap. I would not even think of not putting it on when I lay down. So what should I do? AS far as I know it is the ONLY option on the table, but one that scares me.

    Thanks.

    • Brenna Lara says:

      Hi David,
      Thank you for sharing your afib story and your experience. You may be interested in joining our patient discussion forum (http://forum.stopafib.org/index.php) to connect with other patients who collectively have a great amount of knowledge and experience. You may want to post your story and experience there, and you may also learn a lot from others who have already shared their experience.

      You’ll need to join to see and participate in the discussion. To do so, go to forum.stopafib.org, and click on the big red button that says, “Sign Up”. Once you sign up by registering your email address, your preferred username, and a password, you’ll receive an email to confirm your interest in joining the forum. Click on the confirmation link in that email, and you are ready to go. You’ll be able to log into the forum, read the discussions, and participate. I hope that you are able to find others to connect with there that can give you advice, suggestions, and hope.

      You can view a how-to video here: http://getinrhythm.com/how-to-register-on-forum

      There are many resources on living with afib that you might find helpful.
      For more information on afib and afib management, we have many resources available to you.

      • News Stories on afib http://www.stopafib.org/news.cfm
      • Patient Resources at MyAfibExperience.org
      • Afib Blog
      • Video Presentations from the 2015 Atrial Fibrillation Patient Event

      Best of luck to you! We wish you sinus rhythm.

  3. I am a 61 year old lady and have had paroxysmal atrial fibrillation for 16 years. I used to have atrial flutter also, but that was cured with my first catheter oblation in 2008. In 2011 I had a pacemaker implanted, to help encourage the heart to beat normally, however it made little or no difference to the Afib. In 2015 I had a second catheter ablation, which didn’t help at all. I was starting to have side affects from all the medications I was on and really didn’t think they were doing any good, so in 2016 my consultant decided to do an AV node ablation as he said although it would not cure the Afib, I would no longer feel it and as long as I kept taking the anticoagulants I was not in danger of having a stroke. I went ahead with the AV node ablation, but it hasn’t stopped me feeling the Afib. When I get an episode now, the feeling I get is like when you are frightened or nervous, It’s hard to describe exactly, but if you have ever had that awful feeling of trepidation when it manifests itself physically, that is how I feel for the length of the episode, which can be 36 hours or more. There is nothing more that can be done because I have had the AV node ablation. If I had known how I would feel now, I would not have gone ahead with the AV node ablation.

    • Brenna Lara says:

      Hi Anne,

      Thank you for sharing your afib story and your symptoms and experience. You may be interested in joining our patient discussion forum (http://forum.stopafib.org/index.php) to connect with other patients who collectively have a great amount of knowledge and experience. You may want to post your story and experience there, and you may also learn a lot from others who have already shared their experience.

      You’ll need to join to see and participate in the discussion. To do so, go to forum.stopafib.org, and click on the big red button that says, “Sign Up”. Once you sign up by registering your email address, your preferred username, and a password, you’ll receive an email to confirm your interest in joining the forum. Click on the confirmation link in that email, and you are ready to go. You’ll be able to log into the forum, read the discussions, and participate. I hope that you are able to find others to connect with there that can give you advice, suggestions, and hope.
      You can view a how-to video here: http://getinrhythm.com/how-to-register-on-forum

      There are many resources on living with afib that you might find helpful.
      For more information on afib and afib management, we have many resources available to you.

      • News Stories on afib http://www.stopafib.org/news.cfm
      • Patient Resources at MyAfibExperience.org
      • Afib Blog
      • Video Presentations from the 2015 Atrial Fibrillation Patient Event

      Best of luck to you! We wish you sinus rhythm.

  4. G. Darwyn Cornwell says:

    I am a male, now age 73 …… I would like to share my experiences with AFib, AV Node Ablation, etc., in the hopes it might be helpful and encouraging to a fellow pilgrim suffering with AF …. my journey with AFib began at age 33 (1976) with a diagnosis of “Tachycardia” (an intermittent, occasional “pause/double heart beat”) that began to increase in frequency over the next (3) years …… during the next (10) years, I began experiencing increasingly frequent AFib episodes resulting in innumerable trips to the ER with “Cardizem / Procanimide drips”, new drug therapies, etc. – all to no avail ……. my diagnosis of “lone atrial fib / increasing paroxysmal AF” …. then became a diagnosis of “persistent AF” with increasing intensity and greater frequency of episodes – also accompanied by fainting spells ……. which continued over the next (7) years with no improvements achieved using drug therapies, including several “drug trials” (I tried every drug known/available up to 1996) ….. and, I was becoming fully disabled! ….. so in 1997, I then applied for an “experimental procedure” (at the time) “High-Frequency Radio Catheter Ablation” …. which also failed …. and so, after scores of drug treatments, drug trials at UT Southwest Medical School, untold number of physicians and hospitalizations, etc., et al ….. in (1998, age 55) we all agreed that my only recourse remaining was to undergo a “full AV Nodal Ablation with Pacemaker” at Baylor Hospital (Dallas) ….. there would be “no looking back”! ….. however, I’m so very thankful that I did! ….. my condition immediately improved and I began to slowly resume my lost lifestyle of golf, travel, outdoor sports, and a renewed career ……. amazingly, my heart was just tested and my ejection/fraction has improved over time from approx. 35 to 45! ….. I am now approaching the time for replacement of my third pacemaker ….. and yes, I understand I am totally “PM-dependent’ and I take Coumadin regularly ……… but still, I eagerly look forward to continuing the life adventures that await me in my “70s” …… and enjoying the gift of life this medical procedure made possible for me! ….. may God bless you all! …..

    • Brenna Lara says:

      Hi Mr. Cornwell,

      Thank you for sharing your afib story and your symptoms and experience. You may be interested in joining our patient discussion forum (http://forum.stopafib.org/index.php) to connect with other patients who collectively have a great amount of knowledge and experience. You may want to post your story and experience there, and you may also learn a lot from others who have already shared their experience.

      You’ll need to join to see and participate in the discussion. To do so, go to forum.stopafib.org, and click on the big red button that says, “Sign Up”. Once you sign up by registering your email address, your preferred username, and a password, you’ll receive an email to confirm your interest in joining the forum. Click on the confirmation link in that email, and you are ready to go. You’ll be able to log into the forum, read the discussions, and participate. I hope that you are able to find others to connect with there that can give you advice, suggestions, and hope.

      You can view a how-to video here: http://getinrhythm.com/how-to-register-on-forum

      There are many resources on living with afib that you might find helpful.

      For more information on afib and afib management, we have many resources available to you.
      • News Stories on afib http://www.stopafib.org/news.cfm
      • Patient Resources at MyAfibExperience.org
      • Afib Blog
      • Video Presentations from the 2015 Atrial Fibrillation Patient Event

      Best of luck to you! We wish you sinus rhythm.

  5. Joe Hagan says:

    I had a Pacemaker fitted back in January of this year, but I am still experiencing AF. My Cardiologist is suggesting that I have an AV node ablation And biventricular pacemaker. Should I have this operation?

    • Brenna Lara says:

      Hi Joe,

      Thank you for sharing your afib story and your question. You may be interested in joining our patient discussion forum (http://forum.stopafib.org/index.php) to connect with other patients who collectively have a great amount of knowledge and experience. You may want to post your story and experience there, and you may also learn a lot from others who have already shared their experience.

      You’ll need to join to see and participate in the discussion. To do so, go to forum.stopafib.org, and click on the big red button that says, “Sign Up”. Once you sign up by registering your email address, your preferred username, and a password, you’ll receive an email to confirm your interest in joining the forum. Click on the confirmation link in that email, and you are ready to go. You’ll be able to log into the forum, read the discussions, and participate. I hope that you are able to find others to connect with there that can give you advice, suggestions, and hope.

      You can view a how-to video here: http://getinrhythm.com/how-to-register-on-forum

      There are many resources on living with afib that you might find helpful.
      For more information on afib and afib management, we have many resources available to you.

      • News Stories on afib http://www.stopafib.org/news.cfm
      • Patient Resources at MyAfibExperience.org
      • Afib Blog
      • Video Presentations from the 2015 Atrial Fibrillation Patient Event

      Best of luck to you! We wish you sinus rhythm.

  6. Daniel Abat says:

    I am a 55 year old Heart patient, I have CHF, Cardialmyopathy, along with A-Fib and A-flutter. I have had an ICD implant since 2013. My Doctor has me on many meds. Doctor is suggesting AV node ablation, and I am unsure what to do! Not Feeling to positive after all these reviews! What to do, I am already disabled.

    • Brenna Lara says:

      Hi Daniel,
      Thank you for sharing your afib story and your symptoms. You may be interested in joining our patient discussion forum (http://forum.stopafib.org/index.php) to connect with other patients who collectively have a great amount of knowledge and experience. You may want to post your story and questions there, and you may also learn a lot from others who have already shared their experience.
      You’ll need to join to see and participate in the discussion. To do so, go to forum.stopafib.org, and click on the big red button that says, “Sign Up”. Once you sign up by registering your email address, your preferred username, and a password, you’ll receive an email to confirm your interest in joining the forum. Click on the confirmation link in that email, and you are ready to go. You’ll be able to log into the forum, read the discussions, and participate.
      I hope that you are able to find others to connect with there that can give you advice, suggestions, and hope. There are many resources on living with afib that you might find helpful. Best of luck to you! We wish you sinus rhythm.

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