Thank you for visiting this video segment for Dr. AFib, I'm Dr. Morales.
Today we're going to be talking about a very important topic when it comes to atrial fibrillation,
and its type of procedure called an AV nodal ablation.
Now, first of all, patients when they hear about ablations, they think that everything
is the same and there are many different types of ablations which do different things inside
of your heart and have varying levels of success rate.
But in today's segment, we're going to be specifically talking about what's called an
AV nodal ablation which is a treatment option for patients with atrial fibrillation which
is solely to control your heart rate.
The AV node is in the middle portion of the heart and so when you have atrial fibrillation
the atria or the top portions of your heart are going extremely fast but the pulse comes
from the bottom chamber of your heart which is the ventricles, and that's when you get
the heart beats of 100 beats per minute hundred and fifty extremely fast when you're in atrial
fibrillation that's the pulse or the ventricle.
So, there's a center in an area of the heart called the AV node which basically connects
the top and the bottom portions of the heart, and that's what transmits those fast AFib
signals down to your pulse or your ventricles and so in an AV nodal ablation is we actually
burn that center connection between the top and the bottom.
So, that there's no longer connection between the top and the bottom chambers of the heart
and when you do this the heart can go very slow sometimes 20-30 beats per minute which
is extremely slow, and you can't function with a heart rate being that slow.
Which is why it's frequently done in combination with a pacemaker, or it's done in somebody
who already has a pacemaker in place and so when you burn this AV node, or you do an AV
nodal ablation the natural heartbeat becomes extremely slow 20-30 beats per minute but
your actual pulse will be whatever the pacemaker is set at so if your pacemaker set at 70 or
80 beats per minute your heart rate or your pulse will be at 70 or 80 beats per minute
because the pacemaker is driving all your pulses.
So, this is an easy concept to understand it controls your heart rate for people who
have tried other medications and it just doesn't appear to be working and aren't candidates
for other types of ablation procedures.
When I describe to patients or offer to patients an AV node ablation I frequently tell them
that we have reached the end of the road we have tried other medication options we've
tried other procedure options or you're not candidate for the procedure options and the
AV node ablation is a fairly simple less aggressive way to control your heart rate so that it
can be studied, and people actually do feel better, but the important ramifications of
doing this is that your heart rate will be very slow forever and you'll be requiring
a pacemaker for the rest of your life to help control your heart rate.
So, why would a patient really want to do this or be agreeable to this again I offer
these type of procedure to patients when we have already tried all other options you know
we've tried medications we've tried other ablations nothing seems to work and this can
often be a reasonable treatment option when nothing else is work to help control your
heart rate if people feel better and have a better quality of life after having an AV
node ablation done but it's a very serious ramification so if your doctor is trying to
offer you an AV node ablation please make sure you think about it seriously, make sure
that you have exhausted all other treatment options before you move forward with this
type of ablation because of the ramifications of requiring a pacemaker for the rest of your
life but it is a good treatment option for many patients out there where we're they're
not amenable to other types of procedures or a good candidate’s further procedures
or try medical therapy they're just not working.
So, well but again please think about it seriously if this is something that you're planning
and undergoing.
Thank you for visiting in this video segment for Dr. AFib, I'll see you next time.