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His bundle ablation
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His bundle ablation

I have been advised to have a His bundle ablation.  I currently have a pacemaker and am on maxiumum dose of Verapamil, plus betablockers.  I cannot take amiodarone because I only have one lung, and can't risk the potential toxicity.  I understand that after the procedure I will be complelely dependent on the pacemaker.  My question is whether there is any statistical or other information available on the incidence of pacemaker failure?  I gather that in the event of pacemaker failure my chances of survival would be limited.  I expect that modern pacemakers have only a very slight chance of malfunctioning, but I would be grateful for any thoughts.  Thank you.
Irene
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Dear Irene,

A His bundle ablation is also known as as an AV Node ablation or AV junction ablation and is one method for treating resistent atrial fibrillation.  The advantage is that the heart rate is controlled and no medications other than coumadin are needed for the afib.  The disadvantage is that one is pacemaker dependent and still at risk for stroke because the atrium are still in fibrillation.  Your other options would be medical therapy with different drugs such as dofetalide, sotolol or flecanide or consideration of an atrial fibrillation ablation.  The risk of pacemaker failure is very low indeed and usually there is enough of the heart's own "escape rhythm" that one would not die should the pacemaker stop working.
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Avatar_n_tn
Cardo Biosense. My wife is seemingly rapidly approaching a similar situation. Ablation seems to be a very effective treatment, with what seem to be better than average results. However I recently read on another site of a way of making this even more effective, by being better able to target the location using Cardo Biosense. Unfortunately I find no information anywhere, pertaining to this treatment. Is anyone able to help?
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Avatar_n_tn
I had the AV node ablation and a pacemaker installed last year. I had read about a device that pinpoints the exact location to be "zapped" and mentioned it to my doctor.  He pooh-poohed it, saying that he was constantly being bombarded by the people who make this new device and that he had looked into it and didn't like what he found.  I have had good results from the ablation, but recently my pulse rate has been quite erratic - visit to cardiologist has so far found nothing wrong - Holter monitor next step.
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