AV Node ablation and permanent pacemaker

Sometimes, symptoms related to atrial fibrillation may be due to a high heart rate which is not amenable to being controlled with tablet treatment alone.

It may be suitable to cauterise the AV node (the heart’s junction box) so that the rapid and irregular electrical impulses in the atria (upper chambers) cannot be transmitted down to the pumping chambers and make them contract in a rapid and irregular fashion.

However this makes the heart dependent on having a permanent pacemaker so as to prevent the heart from beating too slowly. This is usually carried out as a two step process with the pacemaker implanted first and then the AV node ablation carried out at a later stage (for example 6 weeks later).

The AV node ablation is irreversible so this treatment is not undertaken lightly, but it may be very effective in improving quality of life in appropriate patients.

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