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What are the Risks of AV Node Ablation and Pacemaker Insertion?

Pacemaker implantation is a very common and low risk procedure and should a complication arise, it will be dealt with at once.

Although most people undergoing pacemaker implantation do not experience any complications, you should be aware of the following risks:

  • Haematoma (blood collection) - this may occur at the pacemaker insertion site. This may be uncomfortable and can take several weeks to settle.

  • Pneumothorax –During the procedure it is necessary to insert the pacemaker leads into your heart via a small vein under the collar-bone. This vein runs very close to the lung and there is a small chance that a small hole could be inadvertently made in the lung (Pneumothorax). Should this occur, it would usually heal by itself. However, occasionally a small tube may need to be inserted to drain out the air. This can be uncomfortable and means spending several extra days in hospital.

  • Lead Dislodgment. – Although a great deal of care is taken in placing the pacemaker leads inside your heart, occasionally one of them moves and will need to be repositioned. This usually occurs in the first 24 hours after the procedure and is detected by testing the pacemaker.

  • Infection – There is a very small chance that the pacemaker will develop an infection. Should this occur, it is usually necessary to remove the pacemaker in order to clear the infection.

AV Node ablation is also a very common and very low risk procedure.

Although most people undergoing AV node ablation do not experience any complications, you should be aware of the following risks:

  • Local bleeding, blood clot or haematoma (blood collection) - this may occur at the catheter insertion site.

  • Perforation or damage - very slight chance that this may occur to either a heart chamber or to the wall of one of the blood vessels.

  • Pacemaker failure – this is an extremely small risk.

Prior to both procedures, if you are taking warfarin, this will need to be stopped for several days (your doctor will advise you exactly). During the time that you are not taking warfarin, there will be a very small chance of a blood clot forming.


Should I have the procedure? Do I need the procedure?

AV node ablation and pacemaker implantation is usually reserved for patients who are fed up with the symptoms of atrial fibrillation which are significantly interfering with their quality of life and their lifestyle and for whom all of the medications are not effective. If you are in this category it is highly likely that you will feel very much better if you have the procedure.


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About Us


Melbourne Heart Rhythm is the arrhythmia service at the Department of Cardiology at the Royal Melbourne Hospital. We are comprised of a team of highly trained and dedicated health care professionals specializing in heart rhythm management. We have a strong focus on patient education and patient centered care. Our arrhythmia specialists have an international reputation of excellence in arrhythmia research and clinical arrhythmia management.