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 the discussion, but before you jump over there, please share your thoughts and comments below. Thanks.

I have had AV nod ablation and a pacemaker,but the Doctor said I was not pacemaker dependent. Can this be?
I have had Afib for two years and I am on deltizam 360mg per day . This controls my blood pressure and heart rate–rate control . I have been recommended an AV node ablation and pacemaker as the best treatment to cure my Afib . When I last had a follow up visit with my cardiologist I mentioned pulmonary ablation using a Stereotaxis or Hansen system and he asked what those systems were !
Terry,
You said: “I have had AV node ablation and a pacemaker, but the Doctor said I was not pacemaker dependent. Can this be?”
The AV node ablation burns out the heart’s natural pacemaker, and the implanted pacemaker takes its place. It doesn’t make sense to me that you would not be “pacemaker dependent.” You might want to ask your doctor to clarify further.
Mellanie
Richard,
It sounds like your doctor is not keeping up. Maybe it’s time to find an electophysiologist (a cardiologist that specializes in heart rhythms).
Mellanie
My afib started when I was 50 years old. I was on many drugs including Amorodian. I was in and out of the hospital sometimes twice a month. My cardiologist finally suggested an ablation. I had to have 4 ablations to finally stop my afib. After the first ablation I had to have a pacemaker. But now, life is great. Instead of spending time running to the emergency room, I have my life back. I feel absolutely nothing and have had a great quality of life that I didn’t have before. Yes, I still have to take coumadin but it is better than going to the emergency room and always being scared to death what was happening with my heart.
Lois,
Congratulations. I’m glad that you found a solution that worked for you.
Mellanie
So, if I have ablation, I will need a pacemaker
Moises,
No, you don’t need a pacemaker for a Catheter Ablation. You do need it with an AV Node Ablation.
Yes, it’s confusing, so please read http://www.stopafib.org/catheter.cfm to understand the difference.
Mellanie