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

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

doi:10.20944/preprints202305.1936.v1

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preprints.org > biology and life sciences > biology and biotechnology > doi: 10.20944/preprints202305.1936.v1

Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

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

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Version 1 : Received: 25 May 2023 / Approved: 26 May 2023 / Online: 26 May 2023 (13:58:57 CEST)

A peer-reviewed article of this Preprint also exists.

Koniari, I.; Gerakaris, A.; Kounis, N.; Velissaris, D.; Rao, A.; Ainslie, M.; Adlan, A.; Plotas, P.; Ikonomidis, I.; Mplani, V.; Hung, M.-Y.; de Gregorio, C.; Kolettis, T.; Gupta, D. Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing. J. Cardiovasc. Dev. Dis. 2023, 10, 272. Koniari, I.; Gerakaris, A.; Kounis, N.; Velissaris, D.; Rao, A.; Ainslie, M.; Adlan, A.; Plotas, P.; Ikonomidis, I.; Mplani, V.; Hung, M.-Y.; de Gregorio, C.; Kolettis, T.; Gupta, D. Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing. J. Cardiovasc. Dev. Dis. 2023, 10, 272.

Abstract

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: A PubMed/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 “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 the implantation of pacemaker, 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 brunch pacing is an innovative modality. Conclusions: Atrioventricular node ablation and implantation of pacemaker 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.

Keywords

Atrioventricular node ablation; His bundle pacing; Cardiac resynchronization therapy; Heart failure; Atrial fibrillation

Subject

Biology and Life Sciences, Biology and Biotechnology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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