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Ablation of the atrio-ventricular (AV) junction 

Ablation of the atrio-ventricular (AV) junction
Ablation of the atrio-ventricular (AV) junction

Yaver Bashir

, Timothy R. Betts

, and Kim Rajappan

Page of

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date: 18 November 2018

Indications for ablation 330

Pacing issues with AV junction ablation 332

Standard right-sided femoral approach 334

Left-sided or transaortic approach 340

The subclavian approach 342

Outcomes and post-procedure management 344

Common pitfalls and troubleshooting 346

In patients with atrial fibrillation where rate control is required, AV nodal blocking agents such as B-blockers, calcium channel blockers, and digoxin are used. Where medical therapy proves ineffective or causes severe adverse effects, catheter ablation of the AV junction (commonly referred to as AV node ablation) is an important and effective means of achieving ventricular rate control. However, a permanent pacemaker must be implanted because the junctional escape rhythm after ablation is typically slow and unreliable (...

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