Long-term outcomes after radiofrequency catheter ablation of the atrioventricular node: The experience of a Portuguese tertiary center

Manuel, Ana Mosalina; Almeida, João; Fonseca, Paulo; Monteiro, J; Guerreiro, Cláudio; Barbosa, Ana Raquel; Teixeira, Pedro; Ribeiro, José; Santos, Emanuel; Rosas, F; Dias, Adelaide; Caeiro, Daniel; Sousa, Olga; Teixeira, Madalena; Oliveira, Marco; Gonçalves, Helena; Primo, João; Braga, Pedro

doi:10.1016/j.repc.2020.05.016

Cited by 8 publications

(2 citation statements)

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“…The benefit of rate control and rate regularization provided by the pace and ablate strategy was confirmed in our study. The slightly higher mortality of 25% after 4 years observed in our cohort as similar to other studies [ 20 , 21 ] might be explained by two factors. First, the use of biventricular stimulation was only 35% in our cohort, and the non-physiological RV pacing likely has contributed to the higher mortality [ 22 ].…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore, the majority of those reinterventions (3.5%) were upgrades without immediate device-related risk for the patients. Nevertheless, optimal implantation techniques (including the use of biventricular pacing or conduction system pacing) and measures to minimize device infections are important for all patients in need of a pacemaker or an ICD, but should particularly be considered for patients planned for a pace-and-ablate strategy [ 20 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

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Sex-Related Differences in Patient Selection for and Outcomes after Pace and Ablate for Refractory Atrial Fibrillation: Insights from a Large Multicenter Cohort

Baumgärtner

Kaelin-Friedrich

Makowski

et al. 2022

JCM

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Background: A pace and ablate strategy may be performed in refractory atrial fibrillation with rapid ventricular response. Objective: We aimed to assess sex-related differences in patient selection and clinical outcomes after pace and ablate. Methods: In a retrospective multicentre study, patients undergoing AV junction ablation were studied. Sex-related differences in baseline characteristics, all-cause mortality, heart failure (HF) hospitalizations, and device-related complications were assessed. Results: Overall, 513 patients underwent AV junction ablation (median age 75 years, 50% men). At baseline, men were younger (72 vs. 78 years, p < 0.001), more frequently had non-paroxysmal AF (82% vs. 72%, p = 0.006), had a lower LVEF (35% vs. 55%, p < 0.001) and more frequently had cardiac resynchronization therapy (75% vs. 25%, p < 0.001). Interventional complications were rare in both groups (1.2% vs. 1.6%, p = 0.72). Patients were followed for a median of 42 months in survivors (IQR 22–62). After 4 years of follow-up, the combined endpoint of all-cause death or HF hospitalization occurred more often in men (38% vs. 27%, p = 0.008). The same was observed for HF hospitalizations (22% vs. 11%, p = 0.021) and all-cause death (28% vs. 21%, p = 0.017). Sex category remained an independent predictor of death or HF hospitalization after adjustment for age, LVEF and type of stimulation. Lead-related complications, infections, and upgrade to ICD or CRT occurred in 2.1%, 0.2% and 3.5% of patients, respectively. Conclusions: Pace and ablate is safe with a need for subsequent device-related re-interventions in 5.8% over 4 years. We found significant sex-related differences in patient selection, and women had a more favourable clinical course after AV junction ablation.

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Section: Discussionsupporting

confidence: 92%