title: Predictors of hospitalization for heart failure and of all-cause mortality after atrioventricular nodal ablation and right ventricular pacing for atrial fibrillation.
abstract: OBJECTIVE
  Atrioventricular junction ablation (AVJA) is a highly effective treatment in patients with therapy refractory atrial fibrillation (AF) but renders the patient pacemaker dependent. We aimed to analyse the long-term incidence of hospitalization for heart failure (HF) and all-cause mortality in patients who underwent AVJA because of AF and to determine predictors for HF and mortality.
  
  
  RESULTS
  We retrospectively enrolled 162 consecutive patients, mean age 67 ± 9 years, 48% women, who underwent AVJA because of symptomatic AF refractory to pharmacological treatment (n = 117) or unsuccessful repeated pulmonary vein isolation (n = 45). Hospitalization for HF occurred in 32 (20%) patients and 35 (22%) patients died, representing a cumulative incidence for hospitalization for HF and mortality over the first 2 years after AVJA of 9.1 and 5.2%, respectively. Hospitalization for HF occurred to the same extent in patients who failed pharmacological treatment as in patients with repeated pulmonary vein isolation (PVI), although the mortality was slightly higher in the former group. QRS prolongation ≥120 ms and left atrial diameter were independent predictors of hospitalization for HF, while hypertension and previous HF were independent predictors of death.
  
  
  CONCLUSIONS
  The long-term hospitalization rate for HF and all-cause mortality was low, which implies that long-term ventricular pacing was not harmful in this patient population, including patients with unsuccessful repeated PVI.
authors.affiliation: Department of Cardiology, Örebro University Hospital, Örebro, Sweden Department of Medicine, Örebro University, Örebro, Sweden anna.bjorkenheim@orebroll.se.
authors.forename: Anna
authors.initials: A
authors.lastname: Björkenheim
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark.
authors.forename: Axel
authors.initials: A
authors.lastname: Brandes
authors.affiliation: Department of Cardiology, Örebro University Hospital, Örebro, Sweden Department of Medicine, Örebro University, Örebro, Sweden.
authors.forename: Tommy
authors.initials: T
authors.lastname: Andersson
authors.affiliation: Clinical Epidemiology and Biostatistics Unit, Örebro University Hospital, Örebro, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Magnuson
authors.affiliation: Sahlgrenska Academy, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Nils
authors.initials: N
authors.lastname: Edvardsson
authors.affiliation: School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: Birger
authors.initials: B
authors.lastname: Wandt
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark.
authors.forename: Henriette
authors.initials: H
authors.lastname: Sloth Pedersen
authors.affiliation: Department of Cardiology, Örebro University Hospital, Örebro, Sweden Department of Medicine, Örebro University, Örebro, Sweden.
authors.forename: Dritan
authors.initials: D
authors.lastname: Poçi
mesh_terms: D017677:Age Distribution; D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality* / Q000628:therapy*; D001283:Atrioventricular Node / Q000601:surgery; D002304:Cardiac Pacing, Artificial / Q000401:mortality*; D017115:Catheter Ablation / Q000401:mortality*; D003131:Combined Modality Therapy / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology
keywords: Atrial fibrillation; Atrioventricular junction ablation; Heart failure; Hospitalization; Mortality