AVN ablation
AVN ablation basics
Purpose
AVN ablation is utilised for patients who have poorly controlled AF, where pharamcological therapy has not been successful in rate control.
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The patient must 1st be implanted with a pacemaker prior to the ablation.
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After the ablation, heart rates will be completely controlled by the pacemaker.
Success rate
>97%
Complications
Overall <1%
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Complications include
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stroke
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hematoma
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arrhythmia
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damage to pacemaker device/leads
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Cardiac perforation/tamponade
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death
AVN ablation
Equipment
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1 venous sheath
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RF ablation catheter (often non-irrigated)
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A 2nd sheath and JSN may be used as backup pacing (doctor preference)
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arterial sheath/access may be required if node is left sided (<7%)
Procedure
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AVN is targeted based on anatomical location.
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EGMs should demonstrate a mixture of A and V signal.
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When ablating in the correct position, fast junctional activity should be seen followed by paced rhythm at the lower rate limit (usually VVI 30 or VVI 40).
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Avoiding ablation of the HIS region will result in a more stable, reliable escape rhythm.
