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Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN

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Jill and Steve Douglas, East Troy, WI 

“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP. 

Faye Spencer, Boise, ID, April 2017

“I think your site has helped a lot of patients.”

Dr. Hugh G. Calkins, MD  Johns Hopkins,
Baltimore, MD

Doctors & patients are saying about 'Beat Your A-Fib'...

"If I had [your book] 10 years ago, it would have saved me 8 years of hell.”

Roy Salmon, Patient, A-Fib Free,
Adelaide, Australia

"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su,
Cavanaugh Heart Center, 
Phoenix, AZ

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient, 
Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA


Videos: Arrhythmias Animations by St. Jude Medical

Three short animations on ‘understanding arrhythmias and treatment options’ from St Jude Medical:

  1. Atrial Flutter: Fast Heartbeat Arrhythmia (fast heartbeat arrhythmia) (:28 sec.) 
  2. Pacemaker Treatment Option (too slow heart beat) (:49 sec.)
  3. Implantable Cardioverter Defibrillator (ICD) (dangerously too fast heart beat) (:57 sec.) 

Transcript of video
Atrial Flutter video transcript:

Atrial flutter starts in the upper chambers of the heart. During atrial flutter, the heart beats anywhere from 240 to 320 times per minute.

In atrial flutter, even though the upper chambers beat rapidly, only one-half to one-third of the electrical impulses reach the heart’s lower chambers. This is because the AV node, a cluster of cells located in the center of the heart between the upper and lower chambers, slows down the electrical signal before it enters the lower chambers.

This keeps the arrhythmia from becoming life-threatening. Atrial flutter can occur constantly or in episodes where the attacks last hours or days and are followed by a period of normal heart rhythm. 

YouTube video playback controls: When watching this video, you have several playback options.

If you find any errors on this page, 
email us. Y Last updated: Friday, September 1, 2017

Return to Instructional A-Fib Videos and Animations

Ablation of the AV Node and Implanting of a Pacemaker

Location of the AV Node

Ablation or Modification of the Atrioventricular (AV) Node and Implanting a Pacemaker

From a patient’s point of view, this is a procedure of last resort. Each heartbeat normally starts in the right atrium where a specialized group of cells called the sinus node generates an electrical signal that travels down a single electrical road (the Atrioventricular [AV] Node) that connects the atria to the ventricles below. By ablating or eliminating this AV Node, your Atrial Fibrillation signals can’t get to the ventricles which does stop your heart from racing.

But for your heart to beat at all or at the proper rate, you must have a permanent pacemaker implanted in your heart for the rest of your life.

An AV Node ablation is irreversible. What’s worse, you still have A-Fib and have to forever take anticoagulants to prevent stroke. Also, patients with Paroxysmal (occasional) A-Fib often develop permanent A-Fib after an AV Node Ablation.

An AV Node ablation is irreversible. What’s worse, you still have A-Fib and have to forever take anticoagulants.

In addition, when you eliminate the AV Node, there is a risk of sudden death because of the ventricles beating too fast. Another factor to be aware of is A-Fib over time may decrease mental abilities and lead to dementia.

Biventricular pacing is generally preferred over uni-ventricular pacing which potentially can worsen or even cause heart failure by one ventricle beating out of sync with the other.

If you have a bad Sinus Node and would need a pacemaker anyway, this procedure might work for you.

But an AV Node Ablation and Pacemaker does work. Patients report an improved quality of life (being able to golf 18 holes) than when A-Fib made their heart race and they were in symptomatic A-Fib.

Last updated: Tuesday, February 20, 2018

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