title: Atrioventricular nodal ablation in patients with resynchronization therapy and atrial fibrillation - long term results.
abstract: OBJECTIVE
  Atrioventricular nodal ablation (AVNA) is recommended for patients (pts) with cardiac resynchronization therapy (CRT) having atrial fibrillation (AF) and incomplete ventricular capture (Class IIa, level B). AVNA reduces mortality and improves the New York Heart Association (NYHA) functional class during intermediate term follow-up. The objectives were to study the long-term outcome regarding quality of life (QoL) and survival of our CRT pts after AVNA.
  
  
  METHODS
  37 CRT-pts undergoing AVNA due to inadequate biventricular pacing were included in the study. Data were retrospectively obtained from clinical records and through telephone interviews.
  
  
  RESULTS
  Twenty pts died during the follow-up period of average 30.6 ± 24 months. After AVNA the ventricular capture improved significantly from 68.4 ± 23% to 98.5 ± 2% (p < 0.001). A significant and sustained improvement of average 0.3 ± 0.5 (p = 0.001) in NYHA functional class was found. Additionally a large percentage of pts discontinued taking rate reducing drugs with potential severe side effects.
  
  
  CONCLUSIONS
  AVNA in CRT pts was safe and effective. The treatment resulted in a sustained improvement in QoL, including long-term improvement in NYHA functional class.
authors.affiliation: a Department for Cardiology , Haukeland University Hospital , Bergen , Norway.
authors.forename: Arleen
authors.initials: A
authors.lastname: Aune
authors.affiliation: a Department for Cardiology , Haukeland University Hospital , Bergen , Norway.|b Department of Clinical Science , University of Bergen , Norway.
authors.forename: Svein
authors.initials: S
authors.lastname: Færestrand
authors.affiliation: a Department for Cardiology , Haukeland University Hospital , Bergen , Norway.
authors.forename: Per Ivar
authors.initials: PI
authors.lastname: Hoff
authors.affiliation: a Department for Cardiology , Haukeland University Hospital , Bergen , Norway.|b Department of Clinical Science , University of Bergen , Norway.
authors.forename: Peter
authors.initials: P
authors.lastname: Schuster
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery*; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects / Q000401:mortality; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009664:Norway; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
keywords: AV nodal ablation; Atrial Fibrillation; Chronic Heart Failure; Quality of Life; Resynchronization therapy