Risks

The risks of atrial fibrillation ablation vary depending on whether you are undergoing a catheter ablation or open-heart surgery, which is less common. Risks include:

• Bleeding or infection at the surgical site or where your catheter was inserted
• Damage to your blood vessels
• Puncture of your heart
• Damage to your heart valves
• Damage to your heart's electrical system, which could worsen your arrhythmia and require a pacemaker to correct
• Blood clots in the legs or lungs (venous thromboembolism)
• Stroke or heart attack
• Narrowing of the veins that carry blood between your lungs and heart (pulmonary vein stenosis)
• Death in rare cases

Discuss the risks and benefits of atrial fibrillation ablation with your doctor to understand if it's right for you.

How you prepare

Your doctor will examine you and order several tests to evaluate your heart condition. He or she will discuss with you the risks and benefits of your atrial fibrillation ablation procedure. Let your doctor know about allergies or reactions you've had to medications. And tell him or her if you're pregnant or planning to become pregnant.

You'll need to stop eating and drinking the night before your procedure. If you take any medications, ask your doctor if you should continue taking them before your procedure. In some cases, you'll be instructed to stop taking medications to treat a heart arrhythmia several days before your procedure.

If you have an implanted heart device, such as a pacemaker or implantable cardioverter-defibrillator, talk to your doctor to see if you need to take any special precautions.

Overview

AV (atrioventricular) node ablation is a treatment for an abnormally fast and disorganized heartbeat called atrial fibrillation. It uses heat (radiofrequency) energy to destroy a small amount of tissue between the upper and lower chambers of your heart (AV node).

If you have AV node ablation, you will need a permanent device implanted to control your heart rhythm (pacemaker).

Why it's done

Your doctor may recommend AV node ablation if you have atrial fibrillation that hasn't improved with medication or other treatments. It's generally considered the last option because it requires the placement of a pacemaker.

What you can expect

Before the procedure

Your doctor will order several tests to check your heart health. Your doctor and nurse will tell you how to prepare and what to bring to the hospital.

After an AV node ablation, a pacemaker is necessary for proper heart function. You may have this device placed several weeks before your ablation to make sure it is working well, or it may be done the day of your ablation.

During the procedure

Cardiac ablation is done in the hospital. A specialist will insert an IV into your forearm or hand and give you medication to help you relax.

During the procedure, you may be awake, lightly sedated or under general anesthesia (fully asleep), depending on your type of arrhythmia and other health conditions.

The doctor inserts the catheter through a blood vessel, usually in your groin, and into your heart.

Sensors on the tip of the catheter apply heat (radiofrequency energy) to the heart tissue at the AV node and destroy the electrical signaling connection.

Once the AV node is destroyed, your doctor implants a pacemaker, unless you already have one. You will need the pacemaker for the rest of your life.

After the procedure

You'll be taken to a recovery area where doctors and nurses will closely monitor your condition. Depending on your condition, you may be allowed to go home the same day or you may spend a night in the hospital.

Results

After AV node ablation, your symptoms and quality of life will likely improve. You will need a permanent pacemaker to control your heart rate, and may need to take blood thinners to reduce your risk of a stroke.