Rate Control Strategy for Afib

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Your doctor may attempt to control your heart rate with medication alone or with a combination of two procedures: an atrioventricular junction ablation (AVJ) and a pacemaker.


Medicines such as beta blockers or calcium-channel blockers slow the time it takes for the electrical impulses to travel through the heart. This forces the heart to maintain a slower rate.

The choice of medication may depend on other medical conditions you have.

AVJ Ablation & Pacemaker

AVJ ablation directs energy at a site in the heart, creating a break in the heart’s electrical circuit. This prevents the irregular impulses from reaching the ventricle, but it results in heart rates that are too slow. A pacemaker is required to increase the heart rate and make it regular.

During an AVJ ablation, your doctor inserts a flexible catheter into a blood vessel in your groin, and a fluoroscope (similar to an X-ray machine) monitors the catheter. Once the catheter reaches the heart, sensors at its tip gather data to help pinpoint the site of the “short circuit.”

Electrical current is then passed through the catheter to heat the tissue at the tip of the catheter. Only a small amount of tissue is destroyed, preventing the electrical impulses from the atria from reaching the ventricles.

After an AVJ ablation, the upper and lower chambers of the heart can no longer communicate, and your bottom chamber will need help to beat at a regular heart rate. This can be done with a pacemaker.