ATTN: AV node ablation people

I'm sorry ya'll, please bear with me and all of my silly questions.
How long does the AV Node ablation take?
Is it as long as a "standard" ablation procedure?
Do they have to do a mapping first?

I don't understand exactly how ablating the AV node eliminates symptoms of flutter. It just doesn't make sense to me.
You still have flutter, a-fib, and palpitations, but because they went in and cut the circuit......you don't feel them anymore?

Someone please help me try to understand. I've read everything I can about it, but I still don't get it.

4 Comments

AV node Ablation

by kcruz - 2009-01-21 02:01:39

Angelie:

AV node ablation are usually short, and no mapping is done. Basically the doc is going to omit the comunnication line from the top of the heart to the bottom of the heart. and your new best friend the pacemaker will do the communication. Most people that are in chronic AF or AFL feel better when this is done, it doesn't alway mean that medication will be omitted though, ( ie if AF and you are on coumadin you will still be taking this medication). and you will be pacer dependant although like in my case I do have a underlying HR of about 30 bpm. Good luck.

Ablation

by maryanne - 2009-01-21 11:01:26

Let me give this a try...and any of you who can add on or give a simpler explanation please do.

First Atrial Fib and Atrial flutter can be caused for a variety of reasons such as but not limited to advanced rheumatic heart disease,mitral or tricuspid valvular disease,cardiomyopathy, thyroid, digoxin toxicity,congestive heart failure or a damaged SA node,trauma or acute myocarditis and pericarditis.

In both Atrial Fib and Atrial Flutter the electrophysiologic mechanism responsible is either what they call "enhanced automacticity or reentry"

Enhance Automaticity is an abnormal condition in which the pacemaker cells firing rate is increased beyond their inherent rate.
Reentry is a condition in which the progression of an electrical impulse is delayed or blocked in one or more segments of the electrical conduction system. This can cause an abnormal generation of single or repetitive electrical impulses in the atria, AV junction, bundle branches and the Purkinje network.

In an ablation the electrophysiologist is trying to determine what is the mechanism of action which is causing the Atrial fib or flutter...is it "enhanced automaticity" or is it a "reentry" issue. Once it has been determined the mechanism they try to "recircut" or block that pathway. If they are successful then you should no longer have the Atrial fib or flutter.

This procedure can take anywhere from 45 mins up until as long as 6 hours. It all depends on how quickly they can find the mechanisim of action and correct it.

If ablations are successful most people can be removed from some if not all of their cardiac medications. People have been known have more than 1 ablation, I have heard of one person having up to 6 ablations.

I hope some of this information helps. You are asking some great questions.

All the best.....Mary Anne

A-flutter and A-fib

by aldeer - 2009-01-21 12:01:32

Angelie.... Wish you the best of luck. My pacemaker was put in first and then the AV-node ablation was done. Both took about an hour total. I do have a total heart block and was told that I would always be in a-fib & a-flutter, but just would not feel it.(so will always be at risk of stroke) I do feel the flutter & fibs at times when completely resting or stressed out, but not usually. For the most part I don't even know there is a pm there. It did take about nine months or so to not have any sore feelings at all. I do swim five days a week and walk everyday and am just on Coreg CR and Tylenol and a baby aspirin and feel great for an 81 year old! aldeer

AV Node Ablation

by clemsongirl - 2009-01-22 03:01:50

I agree with kcruz that the AV node ablation is usually a very short procedure. Mine took about 45 minutes. They know exactly what they are going in there to do - no mapping. I believe if you aren't already on coumadin and have AF that you will have to go on it after the procedure. I was already on it, so no change for me there. Going on coumadin wasn't too hard, you just have to watch what you eat. They say to be eat a consistent amount of foods with vitamin K in there, which I find to be impossible (sorry I just can't schedule to eat a salad on Monday, Wednesday and Friday). I have a salad for beer theory that seems to work pretty good. :-)

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