A-V Node ablations

Various ablation procedures

by Artist - 2016-12-30 22:54:52

The electrical  signals that produce arrhythmias can come from multiple areas in the heart.  I have various arrythmias, but mostly afib.  To zap those they did an ablation called a pulmonary vein isolation on me and did not touch my AV node.  That helped to reduce the frequency and length of afib episodes.  Bottom line is that sometimes more than one ablation might be needed.  I don't know how accurate this is, but my doctor told me that an AV node ablation is rarely done anymore to treat afib and that PVI is the latest technology.  It is possible that another ablation could help to map and identify other cells that are creating your arrythmias.  In my case, the doctor is refusing to take me off medications.  I am taking eliquiis and Sotalol and the sotalol really bothers me. They will not switch my medications without  hospitalizating me so that I can be monitored. So, I am not pushing the issue but have cut my morning dose and am just taking the evening dose. That way I am sleeping when the drug induced fatigue occurs.  If I don't start having arrythmias problens I will probably keep doing this. But, I am not recommending that anone else disobey their doctor' orders.

Congradulations

by BillH - 2016-12-31 01:47:26

On the weight loss and increased exercise (and also healthy eating and stress control).

Recent studies have shown that allow can reduce/stop a significant aount of of AFIB.

As to your AV ablation. That is unusal. The usual practive is to try and ablate the sourc(s) of the AFIB. Even when succesful it can come back and several redo's are needed.

Usually only  when the AFIB can not be controlled with ablation and meds is AV mode ablation is used.

But the good news is that even with the AV node reconnected with the improved lifestyle the AFIB might not return or only be minimal.

My expriences

by DAVID H - 2016-12-31 18:13:49

4 ablations (3rd was aborted), then A-V Node ablation May 2012.  Life's been fine since.  EP's nurse sent me a message this AM stating my A-V Node has NOT "repaired"  itself.  PM is there to guard again too low heartrates. Like I said, the ECG of Dec 21st stated, "  "When compared with ECG of 03-MAR-2016 11:01, Sinus rhythm has replaced Electronic atrial pacemaker."  If my A-V Node were not functioning, how could my heart be in sinus rhythm?

I'll be visiting my heart failure specialist in Feb, who has shown disdain over his counterparts in my area.  In fact, even though he's NOT an EP, he optimized my pacemaker to achieve a 30% increase in my LVEF after my EP attempted the same procedure.  So I can take a hint!  At my EP appt Dec 21, I was in then out in less than 10 minutes.

--Dave-

Definition

by BillH - 2016-12-31 22:39:22

I suspect that what they mean is that the ventricle rate is being controlled by the natural rate defined by the sinus node.

But to do that the PM is detecting the atrial sinus pulse and then triggering the ventricle.

This is the mode that people with heart block are in.

If the sinus node was not working (or you where in AFIB which over ride the sinus node) then the ventricle rate is strictly determined by the PM and any rate response settings.

There are many PM modes and setting. In general PM are set to look for natural sinus activity and if there it does not pulse the atria, but uses that natural pulse to them monitor if the ventricle fires and if not the PM then fires the ventricle.

Sinus rhythm after AV-node ablation

by golden_snitch - 2017-01-01 04:58:09

Hi!

Of course you can have a functioning sinus node and a not functioning AV-node. Sinus rhythm is your atrial rhythm. With complete AV heart block, the pacemaker will track that rhythm and make the ventricles beat in the same rhythm. Anyone with 3rd degree heart block and no sinus node issues has a sinus rhythm and the ventricles are paced.

If you are in sinus rhythm again, you have no or less Afib than before. Usually, the AV-node is ablated in patients with permanent Afib that has not responded to any other therapies. So, typically someone with Afib and AV-node ablation has no sinus rhythm, but Afib (overriding the sinus rhythm) and paced ventricles.

Best wishes!

Nurses response

by DAVID H - 2017-01-01 14:36:44

"Good afternoon. A demand pacemaker is one that monitors your heart rate and steps in when needed to control/assist the heart rate. With your AV node ablation the pacemaker is needed to maintain an adequate heart rate or it would become too slow. The node has not healed and the device is working great at this time but if you experience any irregularity or other symptoms certainly let us know."

From the ER run (for diverticulitis) at St. David's G.T. Hosp :

 Am I incorrectly reading too much into this report?

--Dave--

ER report not EP's

by BillH - 2017-01-02 23:14:12

That was possibly a computer generated report which is often inaccurate.

And not seeing any sign of a heart attack the doctors did not closely look at the EKG.

Just a guess.