Slowing Atrial Fibrillation

Atrial fibrillation is the most common heart rhythm disorder. In atrial fibrillation, abnormal signals from the left atrium completely disrupt the normal rhythm, which becomes irregular and fast. Under these conditions, the heart contracts in a disordered manner and does not pump blood efficiently. In cases where this arrhythmia is persistent and normal electrical function does not resume, your doctor may suggest slowing the atrial fibrillation heart rate. This may help resolve major symptoms such as shortness of breath, fatigue, or even pulmonary edema. As a first step, your doctor will use drugs to slow the heart rate such as beta-blockers, calcium antagonists, or digoxin. If these medications are inefficient or poorly tolerated, your doctor may suggest AV node ablation.

AV node ablation requires two separately scheduled procedures. The first step is a pacemaker implantation. The second step is a block or ablation between the atria and ventricles so the heart rate is controlled by the pacemaker. The implantation procedure typically lasts about half an hour, uses local anesthesia and mild sedation, and often requires a 2 to 3 nights hospital stay. During the procedure, the cardiologist will make a small incision under your collarbone and insert a catheter to access the heart. An insulated wire or lead is positioned in the heart. The leads are connected to the pacemaker device which is implanted beneath the skin in the upper chest.   The pacemaker is able to sense abnormal heartbeats by using electrically sensitive leads. 

The AV ablation procedure typically lasts about half an hour, uses local anesthesia and mild sedation, and requires an outpatient hospital stay. A small puncture in the vein of the groin allows the catheter to access the heart. The catheter is equipped with an electrode that visually records the electrical activity of heart cells. This electrode makes a small burn in the junction between atria and ventriclesThe pacemaker then delivers regulated electric signals to the heart muscle to restore a normal heartbeat. After the procedure, a nurse will check your scar twice a week and remove the stitches after 10 days.

Life with a pacemaker is normal. You can continue sports, driving, and all your usual activities. You will be given an identification card or passport as a PM wearer. Keep fifty centimeters away from induction stove tops. MRI scans are usually possible, but the pacemaker requires a special setting before and after. Patients with pacemakers are asked to announce themselves at the airport security. AV node ablation does not prevent blood clots so anticoagulant medications are required.

AV node ablation is a straightforward procedure when performed by experienced healthcare providers. Ask your doctor or your cardiologist for further details.


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