Document Detail


Long-term follow-up after atrioventricular nodal ablation and pacing: low incidence of sudden cardiac death.
MedLine Citation:
PMID:  11139959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sudden cardiac death (SCD) has been reported in patients with drug refractory AF who underwent AV nodal ablation and pacing. However, whether SCD in these patients is related to the underlying heart disease or to the ablating and pacing procedure remains uncertain. Between May 1987 and January 1997, AV nodal ablation was performed in 585 patients (mean age 66 +/- 11 years) with drug-resistant, paroxysmal (n = 308) or chronic (n = 277) AF in 12 Italian centers. Lone AF was present in 133 patients. After AV junction ablation, patients underwent VVIR (454 patients) or DDDR (131 patients) pacemaker implantation. At a follow-up of 33.6 +/- 24.2 months, 80 (13.7%) deaths were recorded: 40 noncardiac, 23 nonsudden, and 17 sudden cardiac death (3%, 1.04% per year). Among five variables, including age. NYHA functional class, presence of heart disease, paroxysmal or chronic AF, previous embolic events, and LVEF, the presence of heart disease (P = 0.007) and a LVEF < 0.45, (P = 0.003) were associated with a higher risk of SCD. Analysis of SCD-free survival by log-rank test showed a higher incidence of SCD in patients with LVEF < 0.45 (P = 0.0001) and with coronary artery disease (P = 0.005). In this large cohort, a low incidence of long-term SCD after AV nodal ablation and pacing for drug-refractory AF was observed. The presence of underlying heart disease and the extent of baseline LV dysfunction were associated with an increased likelihood of SCD.
Authors:
M Gasparini; M Mantica; M Brignole; F Coltorti; P Galimberti; L Gianfranchi; C Menozzi; G Magenta; P Delise; A Proclemer; S Tognarini; R Ometto; F Acquati; R Mantovan
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  23     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-01-03     Completed Date:  2001-02-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1925-9     Citation Subset:  IM    
Affiliation:
Cardiac Electrophysiology and Pacing Unit, Istituto Clinico Humanitas, Via Manzoni 56 Rozzano, 20089 Milano, Italy. maurizio.gasparini@humanitas.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / surgery*
Atrioventricular Node / surgery*
Catheter Ablation*
Cohort Studies
Comorbidity
Death, Sudden, Cardiac / epidemiology*
Disease-Free Survival
Follow-Up Studies
Heart Diseases / epidemiology
Humans
Incidence
Italy / epidemiology
Pacemaker, Artificial*
Retrospective Studies
Survival Rate
Time
Treatment Outcome

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


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