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AV Nodal Ablation and Pacemaker Implantation Improves Hemodynamic Function in Atrial Fibrillation
Author(s) -
TAKAHASHI YOSHIHIDE,
YOSHITO IESAKA,
TAKAHASHI ATSUSHI,
HARADA TOMOO,
MITSUHASHI TAKESHI,
SHIROTA KINYA,
KUMAGAI KOICHIRO,
NURUKI NORIHITO,
SHIRAISHI TAKAYOSHI,
NITTA JUNICHI,
ITO HIROSHI
Publication year - 2003
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2003.t01-1-00171.x
Subject(s) - medicine , cardiology , ejection fraction , atrial fibrillation , hemodynamics , refractory (planetary science) , ablation , quality of life (healthcare) , heart failure , physics , nursing , astrobiology
In drug refractory and highly symptomatic atrial fibrillation (AF) patients, hemodynamic effects of AV node ablation and pacing therapy (APT) were evaluated. Thirty‐eight patients with drug refractory and symptomatic AF, underwent APT in eight centers in Japan. The outcome of this therapy was assessed in terms of quality‐of‐life, cardiac performance measured by echocardiogram, and plasma ANP and BNP levels before and after APT. Quality‐of‐life assessed by self‐administered semiquantitative questionnaires: WHO QOL 26 (3.0 ± 0.5vs3.4 ± 0.6, P < 0.01) and the Symptom Checklist: Frequency Scale (1.6 ± 0.6vs0.7 ± 0.7, P < 0.01) and Severity Scale (1.3 ± 0.4vs0.6 ± 0.6, P < 0.01), improved significantly 6 months after APT. Ejection fraction (EF) by echocardiogram improved 1 week after APT (59.0%± 13.3%vs63.3%± 11.6%, P = 0.02). Plasma ANP levels in the group ofANP > 40 pg/mLat enrollment significantly decreased 1 month later(P = 0.03), and plasma BNP levels in the group ofBNP > 20 pg/mLat enrollment significantly decreased 1 month later(P < 0.01). In conclusion, APT has beneficial hemodynamic effects, and plasma BNP levels can predict the most optimal candidates for ablation and pacing therapy. (PACE 2003; 26:1212–1217)