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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

"Your book [Beat Your A-Fib] is the quintessential most important guide not only for the individual experiencing atrial fibrillation and his family, but also for primary physicians, and cardiologists."

Jane-Alexandra Krehbiel, nurse, blogger and author "Rational Preparedness: A Primer to Preparedness"



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"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

Dr. Jeremy Ruskin of Mass. General Hospital and Harvard Medical School

"I love your [A-fib.com] website, Patti and Steve! An excellent resource for anybody seeking credible science on atrial fibrillation plus compelling real-life stories from others living with A-Fib. Congratulations…"

Carolyn Thomas, blogger and heart attack survivor; MyHeartSisters.org

"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

Terry Traver, former A-Fib patient

"If you want to do some research on AF go to A-Fib.com by Steve Ryan, this site was a big help to me, and helped me be free of AF."

Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013


Normal heart - SA and AV Node with four chambers

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.

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: Sunday, February 8, 2015

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