Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing
<b>Objective:</b> To review the relevant literature on the use of atrioventricular node ablation and pacing in patients with heart failure and atrial fibrillation. <b>Methods:</b> APubMed/MEDLINE and SCOPUS search was performed in order to assess the clinical outcomes of atri...
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| Format: | Article |
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MDPI AG
2023-06-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/10/7/272 |
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| author | Ioanna Koniari Andreas Gerakaris Nicholas Kounis Dimitrios Velissaris Archana Rao Mark Ainslie Ahmed Adlan Panagiotis Plotas Ignatios Ikonomidis Virginia Mplani Ming-Yow Hung Cesare de Gregorio Theofilos Kolettis Dhiraj Gupta |
| author_facet | Ioanna Koniari Andreas Gerakaris Nicholas Kounis Dimitrios Velissaris Archana Rao Mark Ainslie Ahmed Adlan Panagiotis Plotas Ignatios Ikonomidis Virginia Mplani Ming-Yow Hung Cesare de Gregorio Theofilos Kolettis Dhiraj Gupta |
| author_sort | Ioanna Koniari |
| collection | DOAJ |
| description | <b>Objective:</b> To review the relevant literature on the use of atrioventricular node ablation and pacing in patients with heart failure and atrial fibrillation. <b>Methods:</b> APubMed/MEDLINE and SCOPUS search was performed in order to assess the clinical outcomes of atrioventricular node ablation and pacemaker implantation, as well as the complications that may occur. <b>Results:</b> Several clinical trials, observational analyses and meta-analyses have shown that the “pace and ablate” strategy not only improves symptoms but also can enhance cardiac performance in patients with heart failure and atrial fibrillation. Although this procedure is effective and safe, some complications may occur including worsening of heart failure, permanent fibrillation, arrhythmias and sudden death. Regarding pacemaker implantation, cardiac resynchronization therapy is shown to be the optimal choice compared to right ventricle apical pacing. His bundle pacing is a promising alternative to cardiac resynchronization therapy and has shown beneficial effects, while left bundle branch pacing is an innovative modality. <b>Conclusions:</b> Atrioventricular node ablation and pacemaker implantation is shown to have beneficial effects on clinical outcomes of patients with atrial fibrillation ± heart failure who do not respond or are intolerant to medical treatment. Cardiac resynchronization therapy is the treatment of choice and His bundle pacing seems to be an effective alternative way of pacing in these patients. |
| first_indexed | 2024-03-11T00:58:22Z |
| format | Article |
| id | doaj.art-1502ca64c9f24d1db50c8a87fbc14ceb |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-11T00:58:22Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-1502ca64c9f24d1db50c8a87fbc14ceb2023-11-18T19:49:54ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-06-0110727210.3390/jcdd10070272Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle PacingIoanna Koniari0Andreas Gerakaris1Nicholas Kounis2Dimitrios Velissaris3Archana Rao4Mark Ainslie5Ahmed Adlan6Panagiotis Plotas7Ignatios Ikonomidis8Virginia Mplani9Ming-Yow Hung10Cesare de Gregorio11Theofilos Kolettis12Dhiraj Gupta13Department of Electrophysiology, Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UKDepartment of Internal Medicine, University Hospital of Patras, 26500 Patras, GreeceDepartment of Medicine, Division of Cardiology, University Hospital of Patras, 26500 Patras, GreeceDepartment of Internal Medicine, University Hospital of Patras, 26500 Patras, GreeceDepartment of Electrophysiology, Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UKDepartment of Cardiology, Manchester Heart Institute, University Hospital of Manchester, Manchester M23 9LT, UKDepartment of Cardiology, Manchester Heart Institute, University Hospital of Manchester, Manchester M23 9LT, UKLaboratory Primary Health Care, School of Health Rehabilitation Sciences, University of Patras, 26500 Patras, Greece2nd Department of Cardiology, “Attikon” Hospital, National and Kapodistrian University of Athens Medical School, 12462 Athens, GreeceDepartment of Intensive Care Unit, Patras University Hospital, 26500 Patras, GreeceDivision of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, No.291, Zhongzheng Rd., Zhonghe District, New Taipei City 23561, TaiwanDepartment of Clinical and Experimental Medicine, University of Messina Medical School, 98122 Messina, ItalyCardiovascular Research Institute, Department of Cardiology, Medical School, University of Ioannina, 45110 Ioannina, GreeceDepartment of Electrophysiology, Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UK<b>Objective:</b> To review the relevant literature on the use of atrioventricular node ablation and pacing in patients with heart failure and atrial fibrillation. <b>Methods:</b> APubMed/MEDLINE and SCOPUS search was performed in order to assess the clinical outcomes of atrioventricular node ablation and pacemaker implantation, as well as the complications that may occur. <b>Results:</b> Several clinical trials, observational analyses and meta-analyses have shown that the “pace and ablate” strategy not only improves symptoms but also can enhance cardiac performance in patients with heart failure and atrial fibrillation. Although this procedure is effective and safe, some complications may occur including worsening of heart failure, permanent fibrillation, arrhythmias and sudden death. Regarding pacemaker implantation, cardiac resynchronization therapy is shown to be the optimal choice compared to right ventricle apical pacing. His bundle pacing is a promising alternative to cardiac resynchronization therapy and has shown beneficial effects, while left bundle branch pacing is an innovative modality. <b>Conclusions:</b> Atrioventricular node ablation and pacemaker implantation is shown to have beneficial effects on clinical outcomes of patients with atrial fibrillation ± heart failure who do not respond or are intolerant to medical treatment. Cardiac resynchronization therapy is the treatment of choice and His bundle pacing seems to be an effective alternative way of pacing in these patients.https://www.mdpi.com/2308-3425/10/7/272atrioventricular node ablationHis bundle pacingcardiac resynchronization therapyheart failureatrial fibrillation |
| spellingShingle | Ioanna Koniari Andreas Gerakaris Nicholas Kounis Dimitrios Velissaris Archana Rao Mark Ainslie Ahmed Adlan Panagiotis Plotas Ignatios Ikonomidis Virginia Mplani Ming-Yow Hung Cesare de Gregorio Theofilos Kolettis Dhiraj Gupta Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing Journal of Cardiovascular Development and Disease atrioventricular node ablation His bundle pacing cardiac resynchronization therapy heart failure atrial fibrillation |
| title | Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing |
| title_full | Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing |
| title_fullStr | Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing |
| title_full_unstemmed | Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing |
| title_short | Outcomes of Atrioventricular Node Ablation and Pacing in Patients with Heart Failure and Atrial Fibrillation: From Cardiac Resynchronization Therapy to His Bundle Pacing |
| title_sort | outcomes of atrioventricular node ablation and pacing in patients with heart failure and atrial fibrillation from cardiac resynchronization therapy to his bundle pacing |
| topic | atrioventricular node ablation His bundle pacing cardiac resynchronization therapy heart failure atrial fibrillation |
| url | https://www.mdpi.com/2308-3425/10/7/272 |
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