Acute and long-term outcomes of left-sided atrioventricular node ablation in patients with atrial fibrillation

J Interv Card Electrophysiol. 2020 Dec;59(3):527-533. doi: 10.1007/s10840-019-00642-8. Epub 2019 Dec 18.

Abstract

Purpose: To present our experience regarding acute and long-term outcomes of left-sided atrioventricular node (AVN) ablation in patients with atrial fibrillation (AF).

Methods: A total of 47 patients with AF in whom left-sided AVN ablation via retroaortic approach as a first-line approach were enrolled in this retrospective study. Indications for AVN ablation were high ventricular rate refractory to medical therapy, inappropriate implantable cardioverter defibrillator (ICD) shocks, or loss of cardiac resynchronization therapy (CRT) pacing. Both acute and long-term outcomes were assessed for all participants.

Results: Left-sided AVN ablation was successfully performed in 46/47 (98%) patients without any procedural complication. In the remaining 1 patient (2%), right-sided AVN ablation was performed. No mortality was observed within 30 days of the procedure. Upgrade to CRT was performed in 9 (19%) of the patients. During the median 22.5 months of follow-up, all-cause mortality was 25%. Device interrogations on the last clinical visit revealed complete AV block and intrinsic ventricular rate of < 40 bpm in all patients.

Conclusion: Left-sided AVN ablation is a safe and effective procedure without recurrence during long-term follow-up.

Keywords: AV node ablation; Atrial fibrillation; Left-sided ablation; Long-term outcomes.

MeSH terms

  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / surgery
  • Atrioventricular Node / diagnostic imaging
  • Atrioventricular Node / surgery
  • Cardiac Resynchronization Therapy
  • Catheter Ablation
  • Humans
  • Retrospective Studies
  • Treatment Outcome