English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Among rate control strategies for atrial fibrillation is atrioventricular junction ablation with ventricular pacing. Concerns about the long term safety of this procedure emerge as studies report deleterious effects of right ventricular pac- ing. A cohort of patients having undergone atrioventricular node ablation and right ventricular pacing was retrospectively studied. After 5 years of follow-up, a small decrease in left ventricular ejection fraction was observed and 19% of patients suffered at least one episode of decompensated heart failure, often in association with contributing cardiovascular comor- bidities. Atrioventricular node ablation with pacing can still safely be used in selected patients to control rate in atrial fib- rillation. BACKGROUND Atrial fibrillation (AF) affects 1% of the general popula- tion, with prevalence increasing with age. Management strategies have evolved in the past years, with publication of landmarks studies like the AFFIRM trial (1) that showed the equivalence of rate and rhythm control strategies on total mortality. Evolution in catheter ablation techniques for AF also greatly influenced the way physicians treat AF, and freedom from atrial fibrillation is achieved in more than 75 % of patients following AF ablation (2). Atrioventricular (AV) node ablation and pacing, mostly achieved from the right ventricular apex, (ablate and pace strategy) has been one way to manage uncontrolled rapid atrial fibrillation. Al- though it is a palliative strategy, because patients usually remained in AF, it has shown good results in improving symptoms and quality of life (3) with no adverse effect on survival (4, 5). Others have reported increased mortality if baseline left ventricular systolic function was altered (5) or following pacing at low heart rate in patients with previous rapid AF (6). The ablate and pace strategy is now less com- monly used because there is now ways to cure AF using per- cutaneous techniques, but also in fear of deleterious effects of pacing on left ventricular function (7-9). Nevertheless, some patients who are poor candidate to primary atrial fibril- lation ablation, for example high risk patients with multiple comorbidities, elderly patients, or some who simply refuse the risks inherent to the procedure can still be controlled with AV node ablation and pacing. OBJECTIVE

Long Term Follow-Up After Atrioventricular Node Ablation and Right Ventricular Pacing: Effects on Clinical Events and Left Ventricular Function