Document Detail


Acute and long-term effects of atrioventricular junction ablation and VVIR pacemaker in symptomatic patients with chronic lone atrial fibrillation and normal ventricular response.
MedLine Citation:
PMID:  11291803     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The precise role of irregular ventricular response in atrial fibrillation (AF) has not been fully elucidated. This study examined the independent effects of rhythm regularity in patients with chronic AF. METHODS AND RESULTS: This study included 50 patients who had chronic lone AF and a normal ventricular rate. Among these patients, 21 who underwent AV junction ablation and implantation of a VVIR pacemaker constituted the ablation group; the other 29 patients were the medical group. Acute hemodynamic findings were measured in 21 ablation patients before ablation (during AF, baseline) and 15 minutes after ablation (during right ventricular pacing). Compared with baseline data, ablation and pacing therapy increased cardiac output (4.7 +/- 0.8 vs 5.2 +/- 0.9 L/min; P = 0.05), decreased pulmonary capillary wedge pressure (16 +/- 5 vs 13 +/- 4 mmHg; P = 0.001), and decreased left ventricular end-diastolic pressure (14 +/- 4 vs 11 +/- 3 mmHg; P < 0.05). After 12 months, the ablation group patients showed lower scores in general quality of life (-20%; P < 0.001), overall symptoms (-24%; P < 0.001), overall activity scale (-23%; P = 0.004), and significant increase of left ventricular ejection fraction (44% +/- 6% vs 49% +/- 5%; P = 0.02) by echocardiographic examination. CONCLUSION: AV junction ablation and pacing in patients with chronic AF and normal ventricular response may confer acute and long-term benefits beyond rate control by eliminating rhythm irregularity.
Authors:
K C Ueng; T P Tsai; C F Tsai; D J Wu; C S Lin; S H Lee; S A Chen
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  12     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-04-06     Completed Date:  2001-07-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  303-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology and Cardiovascular Surgery, Chung-Shan Medical and Dental College Hospital, Taichung, Taiwan. ueng@ms1.tisnet.net.tw
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / physiopathology*,  surgery*
Atrioventricular Node / surgery*
Cardiovascular Agents / therapeutic use
Chronic Disease
Female
Heart / physiopathology
Hemodynamics
Humans
Male
Middle Aged
Pacemaker, Artificial*
Prospective Studies
Quality of Life
Reference Values
Severity of Illness Index
Time Factors
Treatment Outcome
Ventricular Function*
Chemical
Reg. No./Substance:
0/Cardiovascular Agents
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2001 Mar;12(3):310-1   [PMID:  11291804 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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