title: A review on atrioventricular junction ablation and pacing for heart rate control of atrial fibrillation.
abstract: Atrioventricular junction ablation with permanent pacemaker implantation is a highly effective treatment approach in patients with atrial fibrillation and high ventricular rates resistant to other treatment modalities, especially in the elderly or those with severe comorbidities. Compared with pharmacological therapy alone, the so-called "ablate and pace" approach offers the potential for more robust control of ventricular rate. Atrioventricular junction ablation and pacing strategy is associated with improvement in symptoms, quality of life, and exercise capacity. Given the close relationship between atrial fibrillation and heart failure, there is a particular benefit of such a rate control in patients with atrial fibrillation and reduced systolic function. There is increasing evidence that cardiac resynchronization therapy devices may be beneficial in selected populations after atrioventricular junction ablation. The present review article focuses on the current recommendations for atrioventricular junction ablation and pacing for heart rate control in patients with atrial fibrillation. The technique, the optimal implantation time, and the proper device selection after atrioventricular junction ablation are also discussed.
authors.affiliation: Laboratory of Invasive Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vlachos
authors.affiliation: Laboratory of Invasive Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Letsas
authors.affiliation: Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Korantzopoulos
authors.affiliation: Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Liu
authors.affiliation: Laboratory of Invasive Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Efremidis
authors.affiliation: Laboratory of Invasive Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Sideris
keywords: Ablation; Atrial fibrillation; Atrioventricular junction; Pacemaker