Atrioventricular node ablation for atrial fibrillation in the era of conduction system pacing.
| Autor: | Joza J; Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada., Burri H; Cardiology Department, University Hospital of Geneva, Geneva, Switzerland., Andrade JG; Department of Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada., Linz D; Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands., Ellenbogen KA; Virginia Commonwealth University Medical Center, Richmond, VA, USA., Vernooy K; Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | European heart journal [Eur Heart J] 2024 Dec 07; Vol. 45 (46), pp. 4887-4901. |
| DOI: | 10.1093/eurheartj/ehae656 |
| Abstrakt: | Despite key advances in catheter-based treatments, the management of persistent atrial fibrillation (AF) remains a therapeutic challenge in a significant subset of patients. While success rates have improved with repeat AF ablation procedures and the concurrent use of antiarrhythmic drugs, the likelihood of maintaining sinus rhythm during long-term follow-up is still limited. Atrioventricular node ablation (AVNA) has returned as a valuable treatment option given the recent developments in cardiac pacing. With the advent of conduction system pacing, AVNA has seen a revival where pacing-induced cardiomyopathy after AVNA is felt to be overcome. This review will discuss the role of permanent pacemaker implantation and AVNA for AF management in this new era of conduction system pacing. Specifically, this review will discuss the haemodynamic consequences of AF and the mechanisms through which 'pace-and-ablate therapy' enhances outcomes, analyse historical and more recent literature across various pacing methods, and work to identify patient groups that may benefit from earlier implementation of this approach. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.) |
| Databáze: | MEDLINE |
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