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Ablating the Imperceptible: A Novel Application of Para‐Hisian Pacing
Author(s) -
IP JAMES E.,
CHEUNG JIM W.,
LIU CHRISTOPHER F.,
THOMAS GEORGE,
MARKOWITZ STEVEN M.,
LERMAN BRUCE B.
Publication year - 2016
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 - 10.1111/pace.12898
Subject(s) - medicine , ablation , atrioventricular node , atrioventricular block , cardiology , atrial fibrillation , ventricular rate , ventricular pacing , block (permutation group theory) , heart failure , tachycardia , sinus rhythm , geometry , mathematics
In some elderly patients with atrial fibrillation, especially in combination with heart failure, a rate control strategy may be preferred. When pharmacological therapy is ineffective or not tolerated, it is reasonable to perform atrioventricular (AV) node ablation with ventricular pacing. We describe a case in which this approach was necessary for management. However, the presence of periprocedural, drug‐induced AV block just before ablation provided a unique and challenging circumstance. We discuss the steps taken to ensure a successful procedure.