PMID- 18272509
OWN - NLM
STAT- MEDLINE
DCOM- 20080611
LR  - 20101118
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 10
IP  - 4
DP  - 2008 Apr
TI  - Long-term outcome of the atrioventricular node ablation and pacemaker 
      implantation for symptomatic refractory atrial fibrillation.
PG  - 412-8
LID - 10.1093/europace/eun020 [doi]
AB  - 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.
FAU - Tan, Eng S
AU  - Tan ES
AD  - Department of Cardiology, Thoraxcenter, University Medical Center Groningen, 
      University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
FAU - Rienstra, Michiel
AU  - Rienstra M
FAU - Wiesfeld, Ans C P
AU  - Wiesfeld AC
FAU - Schoonderwoerd, Bas A
AU  - Schoonderwoerd BA
FAU - Hobbel, Hugo H F
AU  - Hobbel HH
FAU - Van Gelder, Isabelle C
AU  - Van Gelder IC
LA  - eng
PT  - Journal Article
DEP - 20080212
PL  - England
TA  - Europace
JT  - 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
JID - 100883649
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/complications/mortality/*therapy
MH  - Atrioventricular Node/physiopathology/*surgery
MH  - Case-Control Studies
MH  - *Catheter Ablation
MH  - Female
MH  - Follow-Up Studies
MH  - Health Surveys
MH  - Heart Failure/etiology
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - *Pacemaker, Artificial
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2008/02/15 09:00
MHDA- 2008/06/12 09:00
CRDT- 2008/02/15 09:00
PHST- 2008/02/15 09:00 [pubmed]
PHST- 2008/06/12 09:00 [medline]
PHST- 2008/02/15 09:00 [entrez]
AID - eun020 [pii]
AID - 10.1093/europace/eun020 [doi]
PST - ppublish
SO  - Europace. 2008 Apr;10(4):412-8. doi: 10.1093/europace/eun020. Epub 2008 Feb 12.