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Long-term experience of atrioventricular node ablation in patients with refractory atrial arrhythmias

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Abstract

Atrial fibrillation and other atrial tachyarrhythmias are increasing with age and concomitant morbidity. First options in symptomatic patients are drug treatment and catheter ablation. Nevertheless, a considerable number of patients suffer from refractory atrial tachyarrhythmias despite treatment. Atrioventricular node ablation (AVNA) may be helpful in many of these patients. Therefore, we investigated AVNA patients with a long-term follow-up. We enrolled 82 patients with a follow-up longer than 1 year receiving AVNA for drug- and ablation-resistant atrial tachyarrhythmias (AA) in a retrospective manner. Mean follow-up duration was 48 ± 24 months. 50% of the patients initially received AVNA to optimize biventricular pacing in cardiac resynchronization therapy, the other 50% because of refractory symptomatic tachyarrhythmias. Persistent AV block was achieved in every patient. Symptom relief and patient satisfaction were high during follow-up. Due to system upgrades there were 63% of patients with a biventricular system during follow-up. In these patients, left-ventricular ejection fraction (LV-EF) increased by 7% (42–49%) after ablation. AVNA is effective in increasing biventricular pacing as well as for symptom relief in patients with refractory atrial tachyarrhythmias. AVNA should be considered as a valuable option in patients with refractory atrial tachyarrhythmias lacking other treatment options.

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Authors and Affiliations

  1. Clinic for Cardiology II: Electrophysiology, University Hospital Münster, Münster, Germany

    Kevin Willy, Florian Reinke, Christian Ellermann, Patrick Leitz, Kristina Wasmer, Julia Köbe, Philipp S. Lange, Simon Kochhäuser, Dirk Dechering, Lars Eckardt & Gerrit Frommeyer

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  1. Kevin Willy
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  2. Florian Reinke
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  3. Christian Ellermann
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Willy, K., Reinke, F., Ellermann, C. et al. Long-term experience of atrioventricular node ablation in patients with refractory atrial arrhythmias. Heart Vessels 35, 699–704 (2020). https://doi.org/10.1007/s00380-019-01536-5

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