Atrioventricular (AV) Node Ablation
What is Atrioventricular (AV) Node Ablation?
Atrioventricular (AV) Node Ablation is a minimally invasive, catheter-based procedure used to treat certain types of abnormal heart rhythms (arrhythmias) that originate in the upper chambers of the heart. It is especially effective in patients with chronic Atrial Fibrillation (AFib) or supraventricular arrhythmias who continue to experience symptoms despite medication and other therapies.
During the procedure, a Cardiac Electrophysiologist uses radiofrequency energy delivered through a catheter to interrupt the electrical signals traveling between the atria (upper chambers) and ventricles (lower chambers) of the heart. By intentionally creating a complete block of this electrical pathway—known as AV block—the erratic impulses that cause rapid or irregular heartbeats are stopped. As a result, the heart’s rhythm can no longer be driven by the abnormal signals.
Because AV node ablation results in a complete heart block, a permanent pacemaker is implanted during or immediately after the procedure. The pacemaker takes over the role of regulating the heart’s rhythm, ensuring a steady and controlled heartbeat going forward.
This procedure offers significant symptom relief and quality-of-life improvement for patients with refractory arrhythmias when other treatment options have been exhausted.
Benefits & Risks of Atrioventricular (AV) Node Ablation
Benefits
For patients with difficult-to-manage arrhythmias, AV node ablation offers several benefits:
- Effective Heart Rate Control: Prevents the rapid and irregular heart rates caused by supraventricular arrhythmias.
- Symptom Relief: Reduces palpitations, dizziness, fatigue, and shortness of breath associated with rapid heart rhythms.
- Minimally Invasive: Performed using a catheter inserted through a vein in the groin, requiring no major incisions.
- Improves Quality of Life: Allows a pacemaker to take over heart rate regulation, leading to better symptom control.
Risks
While AV node ablation is a safe and effective procedure, potential risks include:
- Bleeding or Bruising: Minor bleeding at the catheter insertion site is common and usually resolves on its own.
- Pacemaker Dependence: After ablation, the heart will rely entirely on the pacemaker for normal rhythm.
- Blood Clots or Stroke: Though rare, catheter procedures carry a small risk of clot formation.
- Infection: A low risk of infection exists at the pacemaker implantation or catheter insertion site.
- Heart Failure Progression: In rare cases, AV node ablation may lead to worsening heart function in some patients.
What to Expect With Atrioventricular (AV) Node Ablation
- Your doctor will perform tests such as an electrocardiogram (ECG), echocardiogram, or Electrophysiology study (EPS) to evaluate your arrhythmia.
- If you do not already have a pacemaker, one will be implanted before the AV node ablation.
- You may need to stop taking certain medications, such as blood thinners.
- Fasting for several hours before the procedure may be required.
- The access site (groin) will be prepped and numbed with a local anesthetic.
During the Procedure
- A catheter is inserted through a vein in the groin and guided to the AV node using imaging technology.
- Radiofrequency energy is applied to destroy the AV node and block the abnormal electrical impulses.
- Once the AV node is ablated, the pacemaker takes over full control of the heart’s rhythm.
- The catheter is removed, and the access site is closed with a small bandage or closure device.
After the Procedure
- Patients are monitored for a few hours and may need to stay overnight for observation.
- Avoid strenuous activities and heavy lifting for a few days.
- Mild bruising or discomfort at the catheter insertion site is normal and should subside quickly.
- The pacemaker will regulate the heartbeat, and most patients experience significant symptom improvement.
- Follow-up visits will be scheduled to monitor pacemaker function and overall heart health.
Am I a Candidate for Atrioventricular (AV) Node Ablation?
- Have persistent atrial fibrillation or supraventricular arrhythmias that do not respond to medications or other ablation procedures
- Experience severe symptoms, such as palpitations, fatigue, or shortness of breath, due to fast or irregular heartbeats
- Have difficult-to-control heart rates despite medication therapy
- Already have a pacemaker or are willing to have one implanted
Your Electrophysiologist will assess your heart condition and overall health to determine if AV node ablation is the right option for you.
Prioritize Your Heart With Advanced Cardiac Care
We are committed to delivering expert treatment options to support your heart health. If you have atrial fibrillation or other supraventricular arrhythmias and are considering AV node ablation, our team is here to provide guidance and reassurance.