Atrioventricular nodal reentrant tachycardia, or AVNRT, is one of the most common types of supraventricular tachycardia. People who experience this condition often deal with sudden episodes of rapid heartbeat that can be both uncomfortable and alarming. For many patients, medication can help control the episodes, but when symptoms are frequent or severe, a procedure called ablation is often recommended. Understanding how to ablate AVNRT is important for patients and families who want to know what to expect from this treatment. The process is highly effective and has become a standard therapy for long-term management of this rhythm disorder.
Understanding AVNRT
AVNRT happens when there is an extra pathway within or near the atrioventricular node of the heart. This abnormal electrical pathway allows impulses to circulate in a loop, causing the heart to beat much faster than normal. While episodes may stop on their own, they can be distressing and sometimes interfere with daily activities.
For most patients, AVNRT is not life-threatening, but it can significantly reduce quality of life. Symptoms can include palpitations, dizziness, shortness of breath, and fatigue. Because of this, many patients seek a permanent solution rather than relying solely on medications.
What Is Ablation?
Ablation is a medical procedure designed to destroy or modify small areas of heart tissue that are responsible for abnormal electrical signals. In the case of AVNRT, ablation targets the slow pathway in the atrioventricular node, which is part of the reentry circuit that causes tachycardia. By eliminating this pathway, the abnormal rhythm cannot continue.
This procedure is minimally invasive, using thin wires called catheters that are inserted through blood vessels and guided to the heart. Energy, usually radiofrequency or sometimes cryotherapy, is delivered to the tissue to stop the abnormal circuit from functioning.
Preparing for AVNRT Ablation
Before the procedure, patients typically undergo a thorough evaluation. This includes
- Electrocardiograms to confirm the diagnosis
- Review of medical history and medications
- Blood tests to assess overall health
- Discussion about risks and benefits with the cardiologist
Patients may be asked to stop certain medications before the procedure, especially drugs that affect the heart rhythm. Fasting for several hours before the ablation is also common.
The Ablation Procedure
On the day of the procedure, the patient is brought into the electrophysiology lab. Sedation or general anesthesia is given to ensure comfort. Catheters are inserted through the groin, arm, or neck veins and carefully advanced into the heart under imaging guidance.
Electrophysiology Study
Before the actual ablation, doctors perform an electrophysiology study. This involves stimulating the heart with small electrical signals to reproduce the abnormal rhythm. This step helps map out the abnormal pathways and confirm the diagnosis.
Ablation of the Slow Pathway
Once the abnormal circuit is identified, energy is delivered to the targeted area. The goal is to eliminate or modify the slow pathway of the atrioventricular node without damaging the normal fast pathway. This requires precision, as damaging the wrong area can cause heart block, which might require a pacemaker.
Testing After Ablation
After ablation, the electrophysiology team will attempt to induce tachycardia again. If it cannot be triggered, the procedure is considered successful. Catheters are then removed, and pressure is applied to prevent bleeding at the insertion site.
Recovery After Ablation
Most patients stay in the hospital for several hours or overnight for monitoring. Groin or insertion site soreness is common but usually mild. Patients are advised to avoid heavy lifting or strenuous activity for a few days to allow proper healing.
Follow-up visits are scheduled to ensure the heart rhythm remains stable. Most people can return to normal activities within a week.
Success Rate and Risks
Ablation for AVNRT has a very high success rate, often above 95 percent. Recurrence of tachycardia is possible but uncommon. Risks include bleeding, infection, damage to blood vessels, and in rare cases, heart block that may require a pacemaker. However, serious complications are rare, and most patients enjoy long-term relief from symptoms.
Benefits of Ablation
There are several advantages to choosing ablation for AVNRT
- Permanent solution with high success rate
- Elimination of or reduction in the need for long-term medications
- Improved quality of life with fewer or no episodes of rapid heartbeat
- Minimally invasive nature with relatively quick recovery
Lifestyle After AVNRT Ablation
After a successful ablation, most patients do not require long-term restrictions. They can exercise, work, and participate in activities without fear of frequent tachycardia episodes. However, it is important to maintain regular checkups and report any unusual symptoms to a healthcare provider.
Healthy habits such as a balanced diet, regular physical activity, and avoiding excessive caffeine or alcohol can further support heart health. Managing stress and getting enough sleep also help reduce the likelihood of arrhythmias.
When to Seek Medical Help
Even after ablation, patients should be aware of warning signs that may require medical attention, including
- Persistent chest pain
- Severe shortness of breath
- Unusual dizziness or fainting
- Signs of infection at the catheter site
While complications are rare, recognizing symptoms early allows for prompt medical care.
Learning how to ablate AVNRT provides reassurance to those struggling with recurrent rapid heart rhythms. The procedure has transformed treatment, offering a highly effective and often permanent solution. By carefully preparing, understanding the steps, and following post-procedure guidance, patients can look forward to a future free from the distress of sudden palpitations. For many, ablation is not only a medical treatment but also a path back to normal living with renewed confidence in their heart health.