title: Ablating the Imperceptible: A Novel Application of Para-Hisian Pacing.
abstract: In some elderly patients with atrial fibrillation, especially in combination with heart failure, a rate control strategy may be preferred. When pharmacological therapy is ineffective or not tolerated, it is reasonable to perform atrioventricular (AV) node ablation with ventricular pacing. We describe a case in which this approach was necessary for management. However, the presence of periprocedural, drug-induced AV block just before ablation provided a unique and challenging circumstance. We discuss the steps taken to ensure a successful procedure.
authors.affiliation: Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, New York.
authors.forename: James E
authors.initials: JE
authors.lastname: Ip
authors.affiliation: Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, New York.
authors.forename: Jim W
authors.initials: JW
authors.lastname: Cheung
authors.affiliation: Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, New York.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Liu
authors.affiliation: Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, New York.
authors.forename: George
authors.initials: G
authors.lastname: Thomas
authors.affiliation: Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, New York.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Markowitz
authors.affiliation: Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, New York.
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Lerman
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy*; D001283:Atrioventricular Node / Q000601:surgery*; D002036:Bundle of His; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans
keywords: ablation; atrial fibrillation; atrioventricular node; complete heart block; para-Hisian pacing