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AV Node Ablation

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AV Node Ablation And Pacemaker Implantation - An Overview

The Atrioventricular Node or AV Node is a vital electrical connection bridging the atria to the ventricles. This AV node is an important passageway for electrical impulses to reach your ventricles.

The AV node ablation is a procedure to eliminate the impact of disorganised or very rapid heartbeats or Atrial Fibrillation. It is a simple procedure wherein radiofrequency energy effectively “knocks out” the AV node. This will prevent any electrical short-circuits in the atria from reaching the ventricles. If you have an AV node ablation, you will need a permanent pacemaker to control your heart rhythm.

Fortunately, if you need an AV node ablation and pacemaker implantation, you have come to the right specialist. Dr. Karthigesan is a Certified Cardiac Device Specialist pioneering in device therapy and interventional cardiology. Thanks to his expertise, thousands of patients have improved their quality of life under his medical care and guidance.

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AV Node Ablation And Pacemaker Implantation: Why is it Necessary?

Dr. Karthigesan may recommend AV node ablation if your A-Fib hasn’t improved with medication or other treatment options. Since it requires the placement of a pacemaker, it is generally considered the last option.

AV Node Ablation And Pacemaker Implantation: Evaluative Tests

Prior to the procedure, you will require the following diagnostic tests, along with your medical history:

  • Electrocardiogram
  • Blood tests
  • Holter monitor test
  • Echocardiogram
  • Stress test
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AV Node Ablation And Pacemaker Implantation: The Procedure

  • AV node ablation and pacemaker implantation can be done in a single sitting or in two different sittings in the same hospital stay.
  • Dr. Karthigesan will perform the pacemaker implantation to normalise your heart rate either before the AV node ablation or after the AV node ablation.
  • During the AV node ablation, a single ablation catheter is inserted through your femoral vein near your groin area.
  • An X-ray imaging machine and ET system (Electrophysiology system) are used to move the catheter inside your heart to identify the AV node and deliver radiofrequency energy to knockout the AV node.
  • The entire procedure will be done after administering local anesthesia and takes upto half an hour.
  • You may still experience rapid heart rhythms in your atria even after the procedure, but you will not experience any rapid heart rhythms.
  • You should also take anticoagulants to prevent any formation of blood clots in the atria.
  • You should stop your other medications that slow your heart rate only after discussing it with Dr.Karthigesan.

Atrioventricular Node Ablation: 
Before, During & After Procedure Care

  • Avoid all anticoagulant medications.
  • Avoid food and drink intake for a minimum of 6 hrs before each procedure.
  • You may have a light breakfast if your appointment is scheduled for the afternoon.
  • Strictly avoid any food or drink intake after midnight the previous day if your procedure is in the morning. However, you may take a few sips of water for medications.
  • The procedure is done in a hospital under sterile clinical conditions.
  • An anaesthetist will administer a mild sedative or general anaesthesia to help you relax during the procedure.
  • The anaesthesia depends on the type of arrhythmia you are experiencing and other medical conditions.
  • After the anaesthetic takes effect, a small bruise is made in your groin, through which a catheter is inserted and guided it to your heart.
  • At the AV node, sensors on the catheter tip apply radiofrequency energy and destroy electrical signalling.
  • When the AV node is ablated, your doctor will perform the pacemaker implantation if you do not have one already.
  • This pacemaker will keep your heart beating for the rest of your life.
  • You will be closely monitored in a special recovery room.
  • Depending on your post-procedure progress, you can return home on the same day. Sometimes you may require a night’s stay at the hospital.
  • Following your doctor’s advice and food restrictions will improve your quality of life after this procedure.
  • You should continue taking blood thinners if your doctor suggests them.
  • You will also require a permanent pacemaker to keep your heart rate under control.

AV Node Ablation and Pacemaker Implantation: The Benefits

  • After an AV node ablation and pacemaker implantation procedure, your heart will function normally with a regular heart rhythm.
  • You will not experience any rapid heartbeats, thanks to the pacemaker.
  • You will no longer depend on medication to control your heart rhythm, although you should stop taking them only on your doctor’s advice.
  • You may experience remarkable progress in your health.
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AV Node Ablation: More Details Here

AV node ablation is a better option for patients with recurring A-Fib characterised by rapid heart rate which often interrupts their quality of life, repeated hospitalisation, and when medications are ineffective. It is usually preferred in elderly people with multiple comorbidities who are not suitable for AF ablation.

  • Conduction system pacemaker
  • Leadless pacemaker
  • Biventricular pacemaker
  • Dual chamber pacemaker
  • Single chamber pacemaker

Generally, pacemaker implantation is a low-risk procedure. Even if any complications arise, they can be dealt with immediately. Nevertheless, you should be aware of the following risks that may rarely occur after pacemaker implantation:

  • Pneumothorax or collection of air outside the lung but inside the pleural cavity.
  • Haematoma or abnormal pooling of blood outside your blood vessels.
  • Dislodgement of pacemaker lead
  • Localised bleeding
  • Perforations of pacemaker lead

Generally, the procedure will last upto an hour. It is performed under sedation in a cardiac catheter lab to help you feel comfortable. The cath lab is a special room designated for these cardiac procedures. It has a patient table and other vital equipment like an X-ray machine, ECG monitors, electrophysiology system, etc.

You may require at least a week for recovery from the symptoms of discomfort and bruising in your groin. Dr. Karthigesan will advise you to avoid heavy lifting, exercising, and driving for five days post-procedure. With adequate rest, your symptoms will gradually ease up in a few days.
Of course. After an AV node ablation procedure and care from Dr. Karthigesan, your symptoms will improve, and you will feel healthier. Your heart rate will need to be controlled permanently with a pacemaker, and you may need to take blood thinners to prevent strokes.
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