Long Term Outcome of Atrioventricular Node Ablation with Pacemaker in Patients with Atrial Fibrillation

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This study was to investigated the long term outcome of Atrioventricular node (AVN) ablation with implantation of a permanent pacemaker (PPM) in patients with atrial fibrillation (AF). Methods: Twenty one patients (59.2±13.8 years) who underwent AVN ablation with implantation of PPM were studied. We divided study population into two group-according to history of catheter ablation (CA) for AF to assess predictors to affect clinical outcome. Results: Seven patients underwent CA for AF before procedure and 14 patients without CA were identified. All but 3 patients had normal left ventricular (LV) systolic function. Indication of AVN ablation with implantation of PPM was AF with slow (n=5) or fast (n=4) ventricular response and AF with sick sinus syndrome in 12 (57.1%). Mean age at procedure was younger (55.8±17.0 years) in prior ablation group than no CA group (61±12.2 years, P<0.001) and mean symptom duration to procedure was significantly shorter in CA group (5.8±8.5 months vs, 12.8±9.7 months, P=0.02). In 11 patients (52.4%), symptoms were still ongoing. CA group demonstrated higher incidence of symptom as compared with no CA group (85.7% vs 41.7%, P=0.06). Conclusions: AVN ablation with PPM implantation is less effective to relief of symptoms. The younger age and shorter symptom duration to procedure were associated with higher incidence of symptomatic clinical outcome.
日本不整脈学会の論文