AV Node Ablation

What is AV node ablation?

Atrioventricular (AV) node ablation is a way to treat atrial fibrillation by damaging part of your heart’s conduction system with a catheter. This minimally invasive treatment uses heat or cold energy to damage your AV node on purpose. Doing this can prevent abnormal heartbeats.

After an AV node ablation, you need a permanent pacemaker to take over the job of sending electrical signals to tell your heart to beat. The intent is to get your heart beating more in sync, which may improve your symptoms and your heart’s strength. Out-of-sync contraction of your atria can lead to weakness in your lower chambers and your whole heart.

The AV node is a small area of tissue that sends heartbeat signals. These signals go from your heart’s upper chambers (atria) to your lower chambers (ventricles).

AV node ablation is serious because it’s not reversible. It’s permanent. That’s why people who have it will need pacemakers for the rest of their lives.

What does this procedure treat?

An AV node ablation procedure treats abnormal heart rhythms that happen in your heart’s upper chambers. Besides atrial fibrillation, this includes atrial flutter and other SVTs. A healthcare provider may recommend AV node ablation when AFib is hard to manage.

AV node ablation may be an option for you if:

• All the other treatments haven’t worked
• You already have a pacemaker
• You can’t take medicines to manage an abnormal heart rhythm due to side effects

How should I prepare for AV node ablation?

If you don’t already have one, you’ll need a permanent pacemaker. You may get it several weeks before your atrioventricular node ablation. Or you may get one in the same procedure or after AV node ablation.

Your healthcare provider will do an EP study. This allows them to map your heart’s electrical signals and find the exact location of your AV node.

What happens during an AV node ablation procedure?

The steps of AV node ablation include:

1. Placing a small IV in your arm and giving you sedatives to make you sleep
2. Numbing an area on your arm, groin or neck
3. Placing tiny catheters (long, thin tubes) into the veins in your arm, groin or neck
4. Monitoring your vital signs and heart rhythm
5. Using X-ray, ultrasound guidance and electrical mapping to move the catheters to your AV node
6. Using a special catheter tip that applies heat or cold energy to burn the AV node

The procedure can take less than an hour to several hours.

What are the potential benefits and risks of AV node ablation?

An atrioventricular node ablation has multiple benefits, like:

• An improved heart rhythm without drugs to control it (you may need to keep taking blood thinners, though)
• Improved symptoms and quality of life
• Ability to get more physical activity
• Fewer hospital stays and emergency visits for heart failure
• A good safety record

Complications are rare, but may include:

• Pericardial effusion
• Abnormal heart rhythms of a different type
• Sudden death
• Decreased function of your left ventricle (which an extra lead in a special pacemaker can fix)

What happens after AV node ablation?

After atrioventricular node ablation, your healthcare provider will remove the catheters. They’ll press (about 15 minutes) on the areas where catheters went into your skin. You’ll need to lie on your back for a few hours.

What is the recovery time?

The recovery time for an AV node ablation procedure is short. You may spend one night in the hospital and go home the next day.

You’ll probably feel tired for a couple of days after your atrioventricular node ablation. You may also feel sore. After a few days, you’ll be able to go back to doing the things you normally do.

One month after you get a pacemaker, you’ll need a follow-up visit with your provider. After that, they’ll want to see you once or twice a year.

What is the success rate of atrioventricular node ablation?

The success rate of AV node ablation is nearly 100%.

When should I call my healthcare provider?

Contact your provider if you have signs of infection (even months after getting your pacemaker). These include: fever, chills or pain around your pacemaker.

Tell your provider if you think your pacemaker isn’t working after AV node ablation. Signs of a failing pacemaker include:

• Dizziness
• Fainting
• Shortness of breath

Are there alternatives to AV node ablation?

Pulmonary vein isolation (PVI) is a similar treatment that you may get instead of an AVN ablation. PVI creates scar tissue to disrupt electrical signals that start in your pulmonary veins and cause AFib.

You may not need a pacemaker after PVI.