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AV Node Ablation

What is the purpose of an AV node ablation?

The purpose of this procedure is to keep the atrial fibrillation (AF) in the atria (top chambers of the heart) and stop electrical signals from going to the ventricles (bottom chambers of the heart) through a part of your heart called the AV node. This procedure helps control your heart rate better and will hopefully decrease your symptoms during an episode of atrial fibrillation.

How is an AV node ablation performed?

On the day of the procedure, the anesthesia team will administer medications to make you go to sleep and a breathing tube may be placed. Your doctor will then insert small, flexible tubes called catheters through the leg veins. Once the catheters are inserted, hot (radiofrequency) energy is used to create a small scar at the AV node. This small scar helps block the abnormal electrical signals from being sent to the ventricles during AF.

Most patients see a lower heart rate after this procedure because the electrical signals to the ventricles are blocked. Therefore, a permanent pacemaker is placed during the procedure to help keep your heart rate in a safe range. If you already have a pacemaker, your doctor will discuss any changes that may be made to your current pacemaker during your pre-procedure appointment.

After the procedure, you will be on bedrest for several hours to prevent bleeding. Patients that have a pacemaker implant with their AV node ablation should plan for an overnight hospital stay. Patients that already had a pacemaker prior to the procedure are typically discharged on the same day after bedrest ends.

How safe is the procedure?

Overall, this is a well-tolerated procedure that has shown to be safe. However, like with all procedures, there are some risks involved. These risks will be discussed with your doctor prior to the procedure.

When should an AV node ablation be discussed?

AV node ablation is typically the last step in managing AF when other approaches have not worked or have too many side effects. Your doctor will carefully consider your case and discuss whether you would benefit from this treatment.

It is important to note that you will still be in AF, but it will no longer affect your heart rate. This can help improve symptoms related to the fast and irregular heart rate that some patients experience during episodes of AF. Sometimes after this procedure there are medications that you can stop taking. However, do not stop taking any medications unless instructed by your doctor.

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