Catheter Ablation | AV Node Ablation

In a few people it proves so difficult to control the symptoms of AF with drugs more invasive treatments need consideration. If an AF ablation is not suitable it may be that we have to opt for a permanent heart rate control method. This involves implanting a pacemaker and then burning the connecting wire between the atria and ventricles. This means that the ventricles work only when the pacemaker stimulates them, thus making them permanently slow. The patient’s heart is dependent on the pacemaker therefore, albeit with many fewer symptoms. Fortunately pacemakers are very reliable these days and this dependence is rarely a problem. Pacemakers do make the heart contract in a slightly different way to normal which in the long-term can worsen its pump function. Fortunately this happens in only a few patients. It is for these reasons that this form of therapy is reserved for the most symptomatic where all other methods have failed.

Like any other ablation procedure the ablation catheter is passed up through a vein at the top of the leg into the heart. The AV node can then be identified and burnt away. This can be performed in virtually every patient on the first attempt. Occasionally more attempts may be needed, perhaps burning on the left hand side of the heart.

As with any other procedure complications can occur although these are rare. It is possible to damage the vein at the top of the leg through which the wires are passed. This usually settles without the need for a small operation. If the patient has a pacemaker already in place it is possible to damage the wires so that they need replacing; again this is very rare.

After the procedure patients need to lie flat for a couple of hours to allow the holes to close up. Patients may need to stay in hospital for a day or two so that the heart rhythm can be monitored depending on the cirucmstances.

London bridge hospital