Treating AFib with AV Node Ablation

AV Node Ablation: One AFib ablation procedure that has been done for years, but is much less commonly done today, is AV node ablation (also sometimes called an AV junctional ablation).

What is the AV node and what does this treatment measure do?

The atrioventricular (AV) node sends electrical signals from the upper to the lower chambers of the heart. In this procedure, the AV node is frozen or cauterized to stop electrical signals from being transmitted to the lower chambers and a permanent pacemaker is implanted to control the heart's electrical system.

What are the expected results from an AV Node Ablation?

  • It is important to understand that an AV node ablation will not stop the heart palpitations and the patient may continue to notice atrial fibrillation. It also will not restore a normal sinus rhythm. Instead, this type of ablation keeps the erratic electrical impulses that occur in the upper chamber, or atrium, from controlling the contraction rate in the lower chamber, or ventricle. After the procedure, the overall contraction rhythm will be managed by the pacemaker.
  • Once completed, some patients no longer feel the fibrillation in the atrium, but many still do. Because the AFib isn’t stopped in this procedure, the patient must stay on an anticoagulant due to the continued risk of stroke.

Who would benefit from an AV node ablation?

AV node ablation is typically the last resort and is used for treating AFib that is untreatable by any other means.

  • It tends to be recommended for elderly patients for whom catheter ablation and surgery are deemed to be too risky.
  • Most afib patients are advised to explore all other recommended treatment options for atrial fibrillation before opting for an AV node ablation.
  • Whether because of the long-term effects of the arrhythmia or because of the AV node ablation itself, many patients may still feel symptoms of general fatigue and tiredness after recovering from this procedure.
  • An AV node ablation may be an option to consider for patients who already have a pacemaker or need one for other reasons.
Recent Discussions From The Providers Office Forum
Wayne avatar

I am a 78-year old male with persistent AFIB for about the last 20 years with only occasional instances of racing heart rate.  In 2010, I had open heart surgery to replace the aortic valve along with a triple by-pass and a cryo-maze procedure to correct the AFIB (the maze procedure only fixed the AFIB for about a month).  In my opinion, I have been doing very well and see my personal physician and cardiologist twice a year.  I keep a good record of my vitals on a weekly basis.  Every so often (2 to 3 times a year) I note that my heart rate (normally 68-70 BPM) while sleeping will dive to the 40's and 50's and stay at that lower rate for a week or two.  Neither of my doctors seem concerned about this.  During my discussion last week with my cardiologist, while discussing this issue, he stated that AFIB can result in low heart rates as well as high heart rates and talked about a pacemaker if and when the low heart rate situation warrants it.  I did not know that AFIB could cause low heart rates and would like to hear if others on this forum have expeienced low heart rates as a result of AFIB.  Thanks.

Trish avatar

Still sifting through the reams of info on ablation. Seems no real consensus on anything except that the centers that do the most have the best outcomes. Saw my lovely, warm dr yesterday for consult on ablation...when or if to do. He is outstanding and I was ready to pull the trigger on the procedure when he told me that since he is at a teaching hospital, his students(fellows) do the ablation with his oversight and correction when needed. I should have realized this but did not. So...the centers that do lots of ablations without student participation narrows the field considerably and let's out some of the major players. Please share any experiences. I am ready and will to travel but would prefer Miami/NYC area. Also, anyone out there have ablation at a teaching hospital?


Deb M avatar

I am going into the hospital next Wednesday for "tikosyn load". My doctor's office is not very forthcoming with information. Can anyone tell me what to expect? How is the load done and monitored? Is the load constant through IV or only at particular times? Do you have to actually lay in a bed for 3 days or can you get up and move around? Can you shower? What should you take to the hospital with you? Were you able to have visitors? How long before you can resume normal activies when you return home? Has being on this medication changed your life style?I would appreciate any advice anyone has. Thank you.

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