AVJ Ablation

[ksig]

I have had AFib for a number of years and it really became bothersome in the summer of 2006.  I had events that lasted 12-18 hours at a time with HR of 230+ at times.  I have had a variety of medicines that did not work to control the rhythm or rate.  I was converted to no avail.  In the winter of 2006 I went to a major university heart center in northern CA and consequently had 2 catheter ablations (Feb 07 and Dec 07) of the left atrium and one for the right atrium for atrial flutter (May 08).  I had a dual lead pacer implant in June 07) I continued to have events so I was put on tikosyn in May 08.  I have a recalcitrant heart as I still have major bouts of AFib.  The EP has scheduled an AVJ ablation as the next course of action.

I am currently on 500mcg tikosyn twice a day, 360 mgdiltiazem XR once a day, 100 mg atenolol once a day  and warfarin

Since my QOL has been hampered over the past couple of years I am ready to be active and travel again.  I am scared as this is a pretty final procedure and there is no going back.  My concern is my future limitations that I may face.   Being a patient in relatively great health (Other than a AFIB) what will I have to look forward to as far as QOL?  Are there other procedures that should be considered before going ahead with the AVJ Ablation?

Thanks,
KSIG

[Brooke_38]

Hello...

As with any choice that we all face, there are pros and cons. Benefits of ablating the AV-Node are, resumption of a regular heart rate (even though a pacemaker may be determining the heart rate), relief from symptoms associated with palpitation, dizziness, syncope. Most likely allowing you to discontinue most of the meds with the exclusion of warfarin.

Potential complications of ablation of the AV node  include bleeding, infection, heart attack, stroke, introduction of air into the space between the lung and chest wall, and death.  These risks are the same for all that choose any type of ablation procedure.  

Candidates for this procedure are those who respond poorly to both chemical and electrical cardioversion. These patients experience repeated relapses of AF, often with rapid rates of ventricular contractions despite medications. Ablation of the AV-Node also  a decent option for Afibber's who develop serious side effects from the medications that are used for treating and preventing AF.

Ablation of the AV node only controls the rate with which the ventricles beat. It does not convert AF to normal rhythm. Because you will still have afib, despite the ablation of the node, you will still need to take your anticoagulant.

I was scheduled for this very procedure this past Aug to treat my afib with rates as high as 280 bpm. However, due to unforseen circumstances it was postponed. For me, the decision wasn't easy, but I felt that if this would bring some quality of life back to me...it was well worth it!

I wish you the best as you come to terms with whatever decision you make. Please update us with your plan and outcome:)

[Jerry_NJ]

I'll reply just to give your post a "bump" to the top of the list again.  

There is a lot of experience among our members with ablation and with pace makers, so I hope you'll get some quality inputs.

Sorry you have to go to that level to stop AFib.   But, I understand you to say your AFib can force your HR to 230+, that has to be stopped.  

I also suffer from AFib, that's what attracted me to your post, but mine doesn't exhibit the high HR you have, I just have a normal high rest rate, but under 100, and I no longer push the heart with heavy exercise/running/HS-biking and the like.

Good luck,