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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is An Av Ablation With An External Placement Of A Biventricular Pacemaker A Surgery ?

family member just released from rural hospital with sudden onset of afib and chf, been in hospital three times this month. This time released to hospice. He is 91 yrs old however appears to be alert, cognative, and with no previous hx of chf. They said he isn't able to have surgery. Question... is an av ablation with an external placement of a biventricular pacemaker in the "surgery" category since both are done interveniously?
Mon, 22 Jun 2015
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Critical Care Specialist,  's  Response
hi,
Sudden onset Afib can precipitate congestive heart failure, and ideally should be reverted (after ruling risks out).
>75% of people at this age can get Afib, and usually is recurrent.
Regarding biventricular pacing, its not possible even after AV Block, because atrial lead would cause no benefit (remain inhibited because of high atrial rate).
But if he goes into frequent heart failure, where rate control cannot be achieved pharmacologically, AV Block with VVO pacing can help. Provided he no high risk in using heparin, which would be used during intervention.
Regards
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Is An Av Ablation With An External Placement Of A Biventricular Pacemaker A Surgery ?

hi, Sudden onset Afib can precipitate congestive heart failure, and ideally should be reverted (after ruling risks out). 75% of people at this age can get Afib, and usually is recurrent. Regarding biventricular pacing, its not possible even after AV Block, because atrial lead would cause no benefit (remain inhibited because of high atrial rate). But if he goes into frequent heart failure, where rate control cannot be achieved pharmacologically, AV Block with VVO pacing can help. Provided he no high risk in using heparin, which would be used during intervention. Regards