Gene157
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Gene157, February 13,  2020  11:59pm EST

Anyone had VA node obliterated and pace maker alone?

Hello

 

My AF is now coming back with flutter at the same time. Really dragging my tail. Taking Sotalol 80mg 2x a day. One option out is to have the VA node destroyed and the  heart controlled by the pacemaker only, sort of a nuclear approach. No return after that. What is it called ?

 

Anyone had that done?

 

Thanks

 

Eugene

  • Thumper2
    Thumper2, February 14,  2020  9:35am EST

    Eugene, this sounds like what I had done, four years ago.  I had no energy at all, and 3 ablations failed to get me into NSR.  I had an AVNA (atrial valve nodal ablation) + PDHBP (Pacemaker Dependent His Bundle Pacing).  It has been a wonderful thing!  Most of my energy is back.  My atria are still fibrillating, but I don't notice that, and my ventricles are beating regularly, due to my pacemaker, which is set at 70 bpm.   By the grace of God, I live not far from the Guthrie Clinic in Sayre, PA, which has a very good Cardiology Department.  Dr. Deshmukh, who did my procedure,  is one of the pioneers in this area.  

    You are right, that there is "no return," but this might be your best option.  Even at the Cleveland Clinic, they had nothing better to offer, for my situation.  However, I always urge folks to get a "second opinion."  I trust you are working with an EP (electrophysiologist) who specializes in the electrical systems of the heart.   Let me know if you have any other questions, and keep us posted!

    Thumper2 (Judy)  

  • Larkspur
    Larkspur, February 14,  2020  12:04pm EST

    Eugene, as you say, there is no return after an AV node ablation. There are a few highly skilled EPs who will take (and very often have success) doing an ablation on complex and difficult patients such as you. Just so you know all your options, why not get a second opinion from one of them?

  • Gene157
    Gene157, February 14,  2020  1:36pm EST

    Thanks for the replies.  4 years is a good time  to see  how well it works, wonderful. Yes I have been getting second opinions, one suggests to live with it and use rate control with Motoprolol, the second (EP) mentioned possible permanent pace maker, one more session with him to final answer.

      I did have the Maze and previous ablation, all worked for only while, couple of years.

    There is a lot of data on this website using : NAV ablation" on search. Scary part is that my ejection fraction has dropped over the last two years from 60-65  to 50 and 71 when under stress with a nuclear test. Biggest drop was after a mitral valve replacement.

     

    Thanks again

     

    Eugene

  • Thumper2
    Thumper2, February 15,  2020  9:38am EST

    Eugene, on my annual ECHO cardiogram, my valves regularly show mild to moderate regurgitation, and my ejection fraction has held steady at 60-65%.  

    Larkspur also recommends a second opinion.  For ablations, the name which most often comes up is Dr. Andrea Natale.  His clinic is in Texas, but apparently he sometimes travels to other parts of the country.  Just a thought.   Keep us posted!

    Thumper2 (Judy)

     

  • maggieNC
    maggieNC, February 16,  2020  7:09am EST

    Eugene -  My husband dealt with A-fib with a series of meds... when the A-flutter joined in, quality of life wasn't there anymore.  Consider sending your second opinion info to Andrea Natale in Austin TX.  His group has staff focused on out of state and out of country reviews.  See what he recommends.  E's ablation was Jan 21.  IN the blanking period, so we will see where we are in the spring.  It has been smooth sailing to date.  Maggie

  • Gene157
    Gene157, February 17,  2020  12:54am EST

    Thank you for that input, I have his number for new patients and will check it out Monday. It will be a third opinion, my second is due on Friday 28

    Eugene

  • Lalabuddy
    Lalabuddy, February 17,  2020  8:18am EST

    Maggie, 

    So glad things went well for your hubby in Texas. I'm going on 3 years afib free now thanks to Dr. Natale. Going to him for my 3rd ablation was the best thing I ever did. Let us know how he's doing.

     

  • Larkspur
    Larkspur, February 17,  2020  11:47am EST

    Gene157, 

    Yes I was thinking of getting another opinion from Dr. Natale. He has been able to get very complex patients who have had many ablations and have flutter, back into stable NSR.  Certainly worth exploring! If you decide to try it, the hospital has a plan for out-of-state patients where you have your consultation one day and your ablation the next. Of course he would have to have reviewed your recorded and accepted you as a patient beforehand. Good luck with this. 

  • maggieNC
    maggieNC, February 18,  2020  8:30am EST

    Eugene & Larkspur - Thought I'd share this if a visit to Andrea Natale becomes a serious consideration...  There is an Air BNB directly across from the entrance to St. David's.  E was just steps away during his time in St. David's.  The cost was less than nicer hotels would have been... Maggie

  • Lalabuddy
    Lalabuddy, February 19,  2020  6:47am EST

    Maggie,

    Would you tell me the name of the Air BNB? We may be heading back to Austin in the next few months. Thanks so much!

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