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During the procedure, a catheter is inserted into a vein in the area of the groin and guided up to the AV node. Radiofrequency energy is passed through the catheter to destroy the node. This eliminates the rapid and irregular heartbeats caused by atrial fibrillation.

Because the pulse rate typically drops to a very slow rate as a result of the procedure, a pacemaker is implanted to increase the heart rate at rest and during exertion or exercise, simulating a normal heart rhythm.

The pacemaker is an electronic device made up of a pulse generator and leads (wires). The device is implanted in the upper chest, under the skin. It is connected to one or two leads that are inserted through a vein into the heart, delivering painless electric pulses that stimulate the heart to beat faster when necessary.

The AV node ablation procedure (including implantation of a pacemaker) takes about three hours to perform and the patient typically spends two nights in the hospital before going home.

AV node ablation with pacemaker implantation has a very high success rate and low risk of serious complications while being effective in alleviating symptoms caused by a rapid and/or irregular heart rate. The procedure also eliminates the need for medications aimed at preventing atrial fibrillation and controlling heart rate.

Because AV node ablation does not cure atrial fibrillation, the patient is dependent on a pacemaker for the rest of his or her life and will have to continue taking a blood thinner to prevent strokes.

There is a 1 or 2 percent risk of a complication during the pacemaker implantation procedure, including:

• Infection
• Puncture of a lung
• Displacement of one of the pacemaker wires, which requires another procedure to reposition the wire in the heart