Document Detail

Long-term outcome of the atrioventricular node ablation and pacemaker implantation for symptomatic refractory atrial fibrillation.
MedLine Citation:
PMID:  18272509     Owner:  NLM     Status:  MEDLINE    
AIMS: To investigate long-term outcome and to determine predictors of development of heart failure (HF) in patients with atrioventricular (AV) node ablation and permanent right ventricular pacing because of symptomatic refractory atrial fibrillation (AF). BACKGROUND: Atrioventricular node ablation and subsequent permanent pacing is a well-established therapy for patients with AF. Long-term right ventricular pacing may induce HF. METHODS AND RESULTS: In 121 (45 with previous HF) patients with drug refractory AF, AV node ablation and implantation of a pacemaker was performed. At baseline and after a mean follow-up of 4.3 +/- 3.3 years, New York Heart Association (NYHA) functional class for HF and left ventricular (LV) and atrial diameters were assessed. During and at the end of follow-up, hospitalizations for HF, mortality, and quality of life were assessed using the SF-36 and an AVN-specific questionnaire. No significant changes in NYHA functional class (87 vs. 77% in NYHA I/II at baseline vs. end of follow-up) and LV end diastolic diameter (51 +/- 7 vs. 52 +/- 8 mm) were observed. Left ventricular end systolic diameter decreased (from 37 +/- 9 to 34 +/- 7 mm, P = 0.03) and fractional shortening improved (from 28 +/- 10 to 34 +/- 9, P = 0.02) in all patients and in patients with previous HF, but not in patients without previous HF. Hospitalizations for HF occurred in 24 patients (20%), predominantly those with previous HF. All-cause mortality occurred in 31 (26%) patients. At the end of follow-up, quality of life was comparable with the control group. CONCLUSION: Long-term outcome of AV node ablation and permanent pacing is good. Atrioventricular node ablation remains a treatment option for AF.
Eng S Tan; Michiel Rienstra; Ans C P Wiesfeld; Bas A Schoonderwoerd; Hugo H F Hobbel; Isabelle C Van Gelder
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Publication Detail:
Type:  Journal Article     Date:  2008-02-12
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  10     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-26     Completed Date:  2008-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  412-8     Citation Subset:  IM    
Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / complications,  mortality,  therapy*
Atrioventricular Node / physiopathology,  surgery*
Case-Control Studies
Catheter Ablation*
Follow-Up Studies
Health Surveys
Heart Failure / etiology
Kaplan-Meiers Estimate
Longitudinal Studies
Middle Aged
Pacemaker, Artificial*
Quality of Life
Retrospective Studies
Risk Factors
Treatment Outcome

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