His bundle ablation followed by VVIR pacing in patients with drug-refractory chronic atrial fibrillation increased mean exercise capacity from 109 W to 118 W (P < 0.002) at 7 months.
Observational (n=25)
Does His bundle ablation followed by ventricular rate response pacing improve exercise capacity in patients with chronic symptomatic drug refractory atrial fibrillation?
His bundle ablation followed by VVIR pacing in patients with drug-refractory chronic atrial fibrillation significantly improves exercise capacity measured in Watts, though peak VO2 remains unchanged.
Absolute Event Rate: 118% vs 109%
p-value: p=< 0.002
OBJECTIVE: To evaluate exercise capacity of patients with chronic atrial fibrillation in whom His bundle ablation followed by ventricular rate response pacing (VVIR) was carried out because of drug refractoriness. DESIGN: Prospective study. PATIENTS: 25 consecutive patients, all with chronic symptomatic drug refractory atrial fibrillation, underwent His bundle ablation. Before this intervention all patients were on antiarrhythmic drugs to attain acceptable heart rate control and to relief symptoms. MAIN OUTCOME MEASURES: Exercise capacity, including measurements of VO2, was examined before and after a mean interval of seven months following His bundle ablation. RESULTS: Exercise capacity after His bundle ablation increased from a mean of 109 (SD 49) W to 118 (46) W (P < 0.002), but VO2 at peak exercise did not change significantly. Maximum exercise capacity was achieved with a significantly lower maximum driven heart rate than the spontaneous heart rate before ablation. CONCLUSIONS: Exercise capacity of patients who underwent His bundle ablation followed by VVIR pacing remained unchanged or improved during a mean follow up of seven months. Larger patient populations with longer follow up are necessary to examine determinants of improved exercise capacity.
Buys et al. (Sat,) conducted a observational in chronic symptomatic drug refractory atrial fibrillation (n=25). His bundle ablation followed by ventricular rate response pacing (VVIR) vs. Baseline (before intervention) was evaluated on Exercise capacity (W) (p=< 0.002). His bundle ablation followed by VVIR pacing in patients with drug-refractory chronic atrial fibrillation increased mean exercise capacity from 109 W to 118 W (P < 0.002) at 7 months.
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