Node view

Av node ablation for atrial fibrillation

How the heart's electrical system works

The heart and the pathways for electrical impulses, with normal EKG results
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slide 1 of 5, How the heart's electrical system works,

In a normal heart, electrical impulses pace the rhythm at which the heart contracts and relaxes. The sinoatrial (SA) node triggers the electrical impulse, causing the upper chambers (atria) to contract. The signal travels through the atrioventricular (AV) node to the atrioventricular bundle, which divides into the Purkinje fibers that carry the signal and cause the lower chambers (ventricles) to contract. The electrocardiogram (EKG, ECG) shows this normal electrical activity.

How atrial fibrillation happens

Erratic impulses in heart during atrial fibrillation, with abnormal EKG results
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slide 2 of 5, How atrial fibrillation happens,

In atrial fibrillation, erratic electrical impulses in the upper chambers of the heart (atria) cause those chambers to fibrillate, or quiver. This results in an irregular and frequently rapid heart rate. The irregular, sawtooth pattern in the electrocardiogram (EKG, ECG) shows these erratic impulses.

Catheter is threaded through a vein to the heart

View of catheter from groin to heart, with detail of catheter in the atrium
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slide 3 of 5, Catheter is threaded through a vein to the heart,

For this non-surgical procedure, catheters are inserted into a vein, typically in the groin or neck, and threaded through the vena cava vein into the right atrium of the heart.

AV node is destroyed

Location of catheter in the heart with detail of electric current destroying AV node
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slide 4 of 5, AV node is destroyed,

An electrode at the tip of the catheter sends out radio-frequency energy, creating heat that destroys (ablates) the atrioventricular (AV) node or other heart tissue that is responsible for the erratic impulses.

Pacemaker controls the heart rhythm

Location of pacemaker in chest, with before-and-after EKG results
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slide 5 of 5, Pacemaker controls the heart rhythm,

When the AV node is ablated, a permanent pacemaker is implanted that paces the ventricle. The pulse generator and battery part of the pacemaker are implanted under the skin of the chest. The electrocardiograms (EKG, ECG) show the heart's electrical activity during atrial fibrillation and when a heart has a pacemaker.

Current as of: August 31, 2020

Author: Healthwise Staff
Medical Review: Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Adam Husney MD - Family Medicine
Martin J. Gabica MD - Family Medicine
John M. Miller MD, FACC - Cardiology, Electrophysiology