AV nodal ablation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]

Synonyms and keywords: AVNA

Overview

Atrioventricular nodal or AV junction ablation is a procedure by which the electrical pathways that connect the atria to the ventricles are modified or interrupted in order to restore a normal cardiac rhythm. This procedure creates a disconnect between the upper chambers (which controls the heart rate and rhythm) and the lower chambers (ventricles). Due to the invasive nature of the procedure and the requirement for a pacemaker implantation, AVNA is mostly as a fallback treatment in patients with atrial fibrillation that is refractory to medications, or have developed side effects to the medications.

Complications and Prognosis

• Development of inappropriate sinus tachycardia. RF ablation in the anterior, mid, and posterior regions of the low interatrial septum may disrupt preganglionic or postganglionic parasympathetic fibers located in these regions that are destined to innervate the sinus node.
• Ventricular fibrillation