Radiofrequency catheter ablation of the AV node in patients with drug-resistant AF significantly improved left ventricular ejection fraction at 6 weeks compared to baseline (47% vs 42%; P<0.05).
Observational (n=14)
Does AV node catheter ablation with RF current improve cardiac performance in patients with drug-resistant AF?
AV node ablation with permanent pacemaker implantation in patients with drug-refractory AF and reduced ventricular function safely improves left ventricular ejection fraction and exercise capacity.
Absolute Event Rate: 47% vs 42%
p-value: p=< 0.05
Patients with atrial fibrillation or atrial flutter (AF) are candidates for radiofrequency (RF) catheter ablation of the atrioventricular (AV) node with the aim being to control heart rate. As patients with AF can have markedly impaired ventricular function, information concerning the hemodynamic effects of AV node ablation using RF current would be valuable. Fourteen consecutive patients (mean age 65 +/- 3 years) with drug-resistant AF underwent AV node catheter ablation with RF current and had permanent pacemaker implantation. The mean left ventricular ejection fraction (EF) by two-dimensional echocardiography immediately before ablation was 42 +/- 3% (range 14%-54%) and their mean exercise time was 4.4 +/- 0.4 minutes. Complete AV block was achieved in all 14 patients with 6 +/- 2 RF applications (range 1-18). There was no evidence of any acute cardiodepressant effect associated with delivery of RF current, and EF 3 days after ablation was 44 +/- 4%. By 6 weeks after ablation, the left ventricular EF was significantly improved compared to baseline (47 +/- 4% postablation vs 42 +/- 3% preablation; P < 0.05), and this modest increase in EF was accompanied by an improvement in exercise time (5.4 +/- 0.4 min). In conclusion, delivery of RF current for AV node catheter ablation in patients with AF and reduced ventricular function is not associated with any acute cardiodepressant effect. On the contrary, improved control of rapid heart rate following successful AV node ablation is associated with a modest and progressive improvement in cardiac performance.
Twidale et al. (Tue,) conducted a observational in Drug-resistant atrial fibrillation or atrial flutter (n=14). Atrioventricular node catheter ablation using radiofrequency current vs. Baseline (preablation) was evaluated on Left ventricular ejection fraction (EF) (p=< 0.05). Radiofrequency catheter ablation of the AV node in patients with drug-resistant AF significantly improved left ventricular ejection fraction at 6 weeks compared to baseline (47% vs 42%; P<0.05).