Document Detail


Effect of Pacing Method on Risk of Sudden Death After Atrioventricular Node Ablation and Pacemaker Implantation in Patients With Atrial Fibrillation.
MedLine Citation:
PMID:  23333719     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the effects of initial pacing at a faster rate after atrioventricular node (AVN) ablation, with a gradual rate decrease over 3 months, on the rate of sudden death in patients with atrial fibrillation. BACKGROUND: Sudden death may occur after radiofrequency catheter ablation of the AVN and permanent pacemaker implantation. It is unclear whether a faster initial heart rate with gradual rate reduction decreases the risk of sudden death. METHODS: We compared the rate of likely or possible procedure-related sudden death in 2 groups of patients who had AVN ablation and pacemaker implantation. The study cohort was treated between January 2005 and December 2009, and pacemakers were programmed to a lower rate of 90 bpm after the procedure, with monthly decrements of 10 bpm until 60 bpm was reached. The control group was treated between July 1990 and December 1998 when pacemakers were programmed to a lower rate of 60 bpm immediately after ablation. RESULTS: The study cohort included 520 patients (mean [SD] age, 73.6 [10.3] years), and the control cohort comprised 334 patients (mean [SD] age, 68.1 [1.1] years). Sudden death deemed likely or possibly related to ablation and pacemaker implantation occurred in 1 patient in the study cohort (0.2%) and in 7 patients (2.1%) in the control group (P=.007). CONCLUSIONS: Sudden death was significantly decreased in the study cohort compared with controls. The faster lower pacing rate immediately after AVN ablation with a gradual decrease is a plausible mechanism for the improved clinical outcome.
Authors:
Ru-Xing Wang; Hon-Chi Lee; David O Hodge; Yong-Mei Cha; Paul A Friedman; Robert F Rea; Thomas M Munger; Arshad Jahangir; Komandoor Srivathsan; Win-Kuang Shen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-17
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier Inc.
Affiliation:
Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China.
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