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.
The patient must 1st be implanted with a pacemaker prior to the ablation.
After the ablation, heart rates will be completely controlled by the pacemaker.
Success rate
>97%
Complications
Overall <1%
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.
