Sinus node ablation

[EMT23]

Looking for anyone who has any knowledge or personal experience with having a sinus node ablation. My EP is seriously considering this as he says we are running out of options for treating my persistent tachycardia. I have had an AVNRT ablation but still have some pretty high rates of tachycardia (150-200bpm) that are not responding well to beta blockers.  EP tells me this tachy is coming from my sinus node. I am aware of the risks of the surgery and am not sure I am ready for a permanent pacemaker. Anyone out there that could offer some experience/advice? Thank you!!!

[researcher09]

Pacemaker will not keep you out of AF.  It will control your ventricular rate and you will still need anticoagulation therapy to prevent blood clots forming in the atria.  Many electrophysiologists have gotten trained in how to do AF ablations over last decade and pacemakers should be the last option unless you are stuck in a clinic that is no good at AF ablations.  Unfortunately, there are still many of those around.

[Bassoongirl65]

Can you explain how the pacemaker keeps you out of afib? Does it monitor high and low, or just low? I was under the impression a defibrillator controls highs.

[Bebegirl123]

Hi
I just had my av node ablated last week...and haven't regretted it for o e second. I feel as of I have my life back after ablations..meds..electric shocks to my heart....I am now fifty eight.....and have life back!
My only regret is that I didn't do it sooner!
Yes it is permanent..yes I still have afib in the top half of my heart..but my ventricles don't race at 190 beats
anymore! For some of us..we have tried it all....and it is a last resort...fore it gave me my life back.....God Bless Pam

[PikaPika88]

Sinus node and AV node, they are totally in different locations.  As I know, they function differently as well.  Are you sure it is the Sinus node ablation?  Not very common.

[ksig]

Hi.  I have experience with this procedure.  I had one after having 4 ablations for AFib and AFlutter.  My AVJ (av node) was performed in March 2009.  It was the best decision I have made and I would do it all over again.  I had just turned 60 when I went through the procedure.  I already had a pacer so I did not have to have one implanted at the time.  I have since had the pacer switched out as it was time to do so.  I am 100% paced and have very little difficulty doing anything I wish to do.  I sail on the San Francisco Bay, go to the gym, walk, etc and have no probs.  I got my first pacer in my early 50s but I know folks who have gotten them in their 20s.  I am off all meds except for coumadin.  I do still have AFib but my pacer beats like the dickens to pace me out of AFib and does a great job doing so.  I used to feel every AFib event and every PAT, PAC etc.  Now I rarely feel the arrhythmia.  That is good for me.  I have energy and have my life back.  My only regret is that I didn't do this procedure much earlier.

This is procedure is not to be taken causally.  You do need to weigh the benefits against the risks.  It took me about 5 months to make the decisions to go ahead with the procedure. I was tired of feeling crappy so I saw that the benefits far outweighed the risks.  Good luck to you.  
ksig

[cindy707]

Thanks so much for the comment.....been so busy with so many things and so little time and you know the story i am sure w. your schedule and family too.......

[EMT23]

Thanks everyone for your advice! I do feel the need to get another opinion after reading some other experiences on here. There are definately pro's and con's to this type of ablation. I could see another EP for a second opinion in my HMO network but they are all in the same clinic so I'm not sure I am really getting a second opinion since they work together. Wishing I could go completely out of the clinic system because another opinion would make me feel much better about going ahead with this procedure. Thanks again for all of your wonderful advice....and Cindy it has been good talking with you again....been missing you on FB. :-)

[cindy707]

I agree w. Toms first post...that would be the LAST resort that i would take on this one....all i know is that the sinus node is the no fly zone of the heart and from everything that i understand and have read and researched once you hit it you are dependent for life on the PM altho like tom also says that times have changed with pacemakers...it is not like it used to be years ago when it was such a barbaric procedure.  I don't know i would seek out anothers opinion as well just to make sure all of your bases are covered on this. As we all know the sinus node is the brain of the heart and it is a scary area to play around with...i would make sure that it for 100% has been confirmed that it is the primary source of your issues before i walked across that bridge.  I'm voting w. Tom.....get a second opinion we only have one heart.................

[tom_h]

When discussing my upcoming ablation with my EP, we were talking about the risks associated with the procedure.  The EP noted that modern pacemakers are amazingly smart devices these days, and can adjust themselves as required by the body.  Can't you stay in your HMO's network, you still find another EP?

[itdood]

I don't have any specific experience with it either.

I did a quick serach of the entire medhelp site from the search bar near the tope of the page, in the middle.  I used the search term "SA node ablation pacemaker".  Do not include the quotes.  I found specific discussion from folks who've had this done, dating back to 2004.  When the results come up, be sure to click the "view all" link.  You should see up to 93 discussions.  Some are spot on, other aren't.  You have to read through them.

There was even some discussion on what happens should the pacmaker fail with doctors from the expert forum.  Good stuff.

[EMT23]

I agree that this is a last resort procedure and not sure I am ready for that last resort...however my family and the physician I work with is encouraging me to go ahead with it. I am 43 y/o female. Unfortunately a second or third opinion is out of the question with my HMO insurance...I can only stay with the clinic system I am already with...however I do have a very good EP who is usually very conservative with treatment and wouldn't do this ablation if he felt it wasn't necessary. But I just have to get to the point of accepting the possibility of a pacemaker which I am not ready for yet.

[tom_h]

Consider this a very uneducated answer, but this sounds like a last result procedure.  If that's the case, I'd want 1 or 2 more opinions before going that route.  Also curious on your age.  Getting a pacemaker at 60 would be much easier to accept than getting one at half of that age.