Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing

Ioanna Koniari, Andreas Gerakaris, Nicholas Kounis, Dimitrios Velissaris, Archana Rao, Mark Ainslie, Ahmed Adlan, Panagiotis Plotas, Ignatios Ikonomidis, Virginia Mplani, Ming Yow Hung, Cesare de Gregorio, Theofilos Kolettis, Dhiraj Gupta

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)

Abstract

Objective: To review the relevant literature on the use of atrioventricular node ablation and pacing in patients with heart failure and atrial fibrillation. Methods: APubMed/MEDLINE and SCOPUS search was performed in order to assess the clinical outcomes of atrioventricular node ablation and pacemaker implantation, as well as the complications that may occur. Results: Several clinical trials, observational analyses and meta-analyses have shown that the “pace and ablate” strategy not only improves symptoms but also can enhance cardiac performance in patients with heart failure and atrial fibrillation. Although this procedure is effective and safe, some complications may occur including worsening of heart failure, permanent fibrillation, arrhythmias and sudden death. Regarding pacemaker implantation, cardiac resynchronization therapy is shown to be the optimal choice compared to right ventricle apical pacing. His bundle pacing is a promising alternative to cardiac resynchronization therapy and has shown beneficial effects, while left bundle branch pacing is an innovative modality. Conclusions: Atrioventricular node ablation and pacemaker implantation is shown to have beneficial effects on clinical outcomes of patients with atrial fibrillation ± heart failure who do not respond or are intolerant to medical treatment. Cardiac resynchronization therapy is the treatment of choice and His bundle pacing seems to be an effective alternative way of pacing in these patients.

Original languageEnglish
Article number272
JournalJournal of Cardiovascular Development and Disease
Volume10
Issue number7
DOIs
Publication statusPublished - Jul 2023

Keywords

  • atrial fibrillation
  • atrioventricular node ablation
  • cardiac resynchronization therapy
  • heart failure
  • His bundle pacing

ASJC Scopus subject areas

  • General Pharmacology, Toxicology and Pharmaceutics
  • Pharmacology (medical)

Fingerprint

Dive into the research topics of 'Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing'. Together they form a unique fingerprint.

Cite this