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Is An Ablation Of The AV Node And Placement Of Pacemaker The Right Treatment For Arrhythmia?
Question: I have had incessant SVT for the Past 9 Years 1 Failed ablation and also 2 repeat EP Studies that failed to Trigger an arrhythmia, even though Atrial Tachycardia was documented on an Event monitor. Have been on various Rate controlling medications in the past all with varying degrees of success. I have episodes at least twice a day with Heart rates of up to 200BPM.Am currently taking Maximum dose Calcium Chanel blocker and another Anti-arrhythmic Drug.Is an ablation of the AV node and placement of a permanent pacemaker worth even considering yet or do I just have to learn to live with this ?
Brief Answer:
I would recommend better to respect natural physiology.
Detailed Answer:
Hello! Thank you for asking on HCM! Regarding your concern, I would explain that ablation of AV node coupled with pacemaker placement is an available option, judging your clinical scenario. But, I would not be so easy in favor of that implantation, considering your age, and several drawbacks associated with pacemakers (infections, right heart adverse functionality implications,etc), though appearance of lead-less pacing opens a new window to explore. I would be more in favor to respect normal physiology, that is to preserve AV node and native cardiac performance to the expense of some episodic SVTs. There are some option I would personally recommend: (1) Repeat EPS and eventual arrhythmia focus ablation in another alternative specialized center, (2) Try alternatively more appropriate anti-arrhythmic combinations, (3) Avoid potentially obvious triggering factors (excessive caffeine, avoid smoking contacts, heavy drinks, follow a healthy life-style, avoid stressful backgrounds, etc).
At the end, it is noticed that SVT generally diminish in frequency and severity with time.
Hope to have been helpful to you. Greetings! Dr. Iliri
I would recommend better to respect natural physiology.
Detailed Answer:
Hello! Thank you for asking on HCM! Regarding your concern, I would explain that ablation of AV node coupled with pacemaker placement is an available option, judging your clinical scenario. But, I would not be so easy in favor of that implantation, considering your age, and several drawbacks associated with pacemakers (infections, right heart adverse functionality implications,etc), though appearance of lead-less pacing opens a new window to explore. I would be more in favor to respect normal physiology, that is to preserve AV node and native cardiac performance to the expense of some episodic SVTs. There are some option I would personally recommend: (1) Repeat EPS and eventual arrhythmia focus ablation in another alternative specialized center, (2) Try alternatively more appropriate anti-arrhythmic combinations, (3) Avoid potentially obvious triggering factors (excessive caffeine, avoid smoking contacts, heavy drinks, follow a healthy life-style, avoid stressful backgrounds, etc).
At the end, it is noticed that SVT generally diminish in frequency and severity with time.
Hope to have been helpful to you. Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Thanks! Your help is appreciated.
Brief Answer:
You are welcome!
Detailed Answer:
You are welcome! Feel free to ask me whenever you need. My Best Wishes!
You are welcome!
Detailed Answer:
You are welcome! Feel free to ask me whenever you need. My Best Wishes!
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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