Atrioventricular ablation, is it useful?

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Dear Friends, I am 52 relatively fit with AF for over 20 years.  I have had 3 ablations and 6 cardioversions, but to no good effect.  The cardiologists is now talking about ablating the atrioventricular node and putting in a pacemaker, has anyone experienced this?

Thanks

Patrick

 

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  • Posted

    Hi Patrick, 

    I’m 35 years old, 3 ablations in and 2 cardioversions. 

    I’ve been told I have one more ablation chance and then ablation of the AV node and pacemaker is my last step. 

    If I’m honest it all scares me a bit..... being 100% reliant on a machine mentally takes up a lot of head/emotional space! 

    Saying that, I always try to be greatful for the care that I have and the technology that is available; if that is my last option to living a AF free life then I’m just going to have to suck it up and deal. 

    However, saying that, I’d be really interested to hear from anyone who has had it done to hear how physically and mentally you are getting on. 

    I wish you all the very best Patrick, please let us know how you get on. 

    Very best wishes, 

    Lynn 

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    • Posted

      Hello Lynn, thanks for such a clear response.  The question I have at this time is whether my quality of life is that bad to warrant an AV ablation.  On the one hand, my health is good and I can do most things, the challenge is however is that high level sport is not at the moment possible, due to it making me faint. However is this sport problem a sufficiently large disadvantage to warrant such an irreversible procedure.  This is my dilemma. 

      The literature seems to suggest that the procedure is safe and has good outcomes.

      How are you managing AF, is is a major impediment to normal living?

      P

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    • Posted

      Hi Patrick, 

      yes, I guess that is the question you need to figure out for yourself, as you say, it’s not a reversible procedure. 

      My quality of life is up and down. Every time I have a AF attack (every other day max 180bpm)  it’s very different but I’m always symptomatic either tightness of chest, shortness of breath, vibrating chest, dizzy etc. 

      I would like to have children but with my AF it’s just not possible for me to carry at the moment. 

      Do you get palpitations and shortness of breath etc when you are in AF? 

      Best, 

      Lynn 

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    • Posted

      Hello Lynn, yes I do get symptoms, but they are not bad, but I wonder after 20 years (the last 2 years I am in permanent AF), I am simply getting used to them, I simply do not know.  Your symptoms sound very debilitating. At your age you should have your atrium size monitored as this may dictate your decision making.  After 20 years mine is very large, although all other heart structures and functions (apart from heart beat) appear to be fine.

      P

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  • Posted

    I have had 3 ablations, the last one two years ago. Still getting runs of AF plus lots of ectopics which are just as uncomfortable. I am also fairly fit and just carry on. I don't like having to take Flecanide daily.I have just read an item on Dr Sanjay Gupta's Facebook page where a patient asks him this very question. The person was 35 and he felt it was too young to have a pacemaker but otherwise saw no problem.

     

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  • Posted

    It is usually a procedure suggested to much older patients than you. In your lifetime you would also need a few changes of pacemaker when the battery ran down.

    The AFA Association have a booklet you can download or have sent to you called Ablation for Atrial Fibrillation (AF)   

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  • Posted

    I had a pacemaker implanted over a year ago because of very low heart rate.  Subsequent checks have shown that I am 97% pacemaker reliant -- which is both a little scary but also shows I really needed it.  Most times I don't even realize I have it.  I've also had two ablations, the second appears to have been successful in putting my a-fib into remission.  The part is that I've been able to get off all my meds with their terrible side affects except for eliquis, and that has been my goal.  Simply put, if the docs say you need a pacemaker, get it -- it's one of the things that will keep you alive.  Good luck.   

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  • Posted

    Hi Patrick - I have had 5 ablations and cannot have any more.  I had my last ablation in April, and have had three attacks since then, the latest tonight.  I have just spent 5 hours in A&E and had a pulse of 240bpm at one stage.  I would be to afraid to fly or go anywhere away from a major hospital.  I have been told that the pacemaker option is the only road left for me, so I am weighing it all up. A cardiologist told me 'don't have a pacemaker unless you have to, they come with their own problems'.  So it is different for each person, and the decision is a very personal one.

    Best wishes

    Theresa

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    • Posted

      I am not in AF all the time, but when I have AF attacks, my bpm is around 140, but if I move or get up, it shoots up to horrendous levels.  I forgot to mention in my last message, that the cardiologist has told me that having the AV node ablated and relying totally on the pacemaker, does NOT actually stop the atria fibrillating, but that the electrical signal now bypasses the atria and the heart beats 'normally', but that in some patients the symptoms of AF will continue to be felt, which is not what you want.  He said ' a lot of people don't understand this'. So, it is not a 'cure'.  

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    • Posted

      Thanks Theresa, those rates must be very uncomfortable.  So even with a pacemaker and AV ablation and a normal ventricular beat, one can feel the AF?  That is not good!
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