Re: Re :Av node ablation and implantation of pacemaker

Posted By annibrahim on May 23, 1999 at 14:35:45
Dear Cardio Dr.
I have been experiencing inappropriate sinus tachycardia for 17 years and although I am mildly asthmatic I was treated with beta blockers and until now this has successfully controlled the tachycardia. However in the last 18 months I have been plagued by asthma symptoms and the tachycardia has aslo got worse - it breaks through the beta blockade. As a result of this |I have been hospitalized a few times for the arrhythmia.
I had an electrophysiology study carried out and the doctors could not find  an extra pathway and I was diagnosed with IST in February 1999. I then underwent a sinus node modification at the Royal Brompton Hospital , London which failed to solve the problem. I have been offered the chance of another ablation but if this fails I am told that my AV node must be destroyed and a permanent pacemaker implanted. I would be grateful if you could advise me on the following: Would I be pacemaker dependent following AV Nodal ablation and if so, what would happen if the pacemaker malfunctioned. Are pacemakers very reliable these days? I'm sorry this message is a bit long, but I,m  really worried about the procedure. I have no choice but to go ahead as I've tried all the meds and my doc says this may be the price I'll have to pay to get rid of my symptoms. Thanks a lot for your time.

[CCF CARDIO MD DLB]

Posted By CCF CARDIO MD - DLB on May 23, 1999 at 15:41:19
Dear annibrahim
If your AV node is ablated, you would be almost 100% dependent on the pacemaker. However, there are many people in this situation. Pacemakers today are very safe. When they fail, it is almost never suddenly, but gradually over months, allowing time for doctors to take corrective measures. Pacemaker technology has greatly improved over the last few years and continues to evolve.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[An-Ibrahim]

Posted By Ann Ibrahim on May 27, 1999 at 15:18:01
Thank you for your reply to my recent enquiry about AV node ablation and implantation of pacemaker, the information was reassuring., Sice then however I have been told about a condition which has similar symptoms to inappropriate sinus tachycardia. Its called Orthostatic Intolerance or Pots. How can I be sure that the condition I have is IST and not POTS. How would these conditions be differentiated? I want to be sure before I have my AV Node ablated.
I had an EPS and sinus mode modification carried out in February . Symptoms still the same.  Main symptom is tachycardia . However recent symptoms are visual disturbances, throbbing head and weakness on standing (sometimes). Doctors put this down to medication. My blood pressure does not drop when I stand and the tests for circulating catecholamines were normal. Doctors want me off beta blockers sooner rather than later because of asthma as other drugs do not control the arythmia, a  pacemaker is in the pipeline. Would this still be the case if the problem was POTS and not IST. Thanks for all your help. You all do a great job!!










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