April 30, 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.


  1. 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.