Key result
AV node ablation plus CRT provides an effective definitive strategy for refractory AF with HF.
Why the study?
Heart failure and atrial fibrillation often coexist and worsen patient prognosis and quality of life, presenting an ongoing management challenge.
Does atrioventricular node ablation combined with cardiac resynchronization therapy improve symptoms and mortality in patients with heart failure and atrial fibrillation?
Does atrioventricular node ablation combined with cardiac resynchronization therapy improve symptoms and mortality in patients with heart failure and atrial fibrillation?
Atrioventricular node ablation combined with CRT is a definitive and effective solution for managing patients with coexisting heart failure and atrial fibrillation who are refractory to medical therapy.
Supports AV node ablation plus CRT in refractory HF-AF; leaves open need for randomized confirmation of mortality benefit.
Heart failure and atrial fibrillation are two diseases that often coexist and contribute to worsening the prognosis and quality of life of patients. Managing this situation is still a challenge today. The ablation of the atrioventricular node associated with cardiac resynchronization therapy (CRT) fits into this context as a definitive but effective solution. Indeed, long-term positive results have been demonstrated in patients with atrial fibrillation ineligible for ablation and refractory to medical therapy in terms of symptom reduction and, more recently, also mortality. Furthermore, the role of this strategy in obtaining adequate biventricular pacing in patients who may benefit from CRT but are ineligible due to the presence of atrial fibrillation is being highlighted.
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Bianchi et al. (2022) conducted a review in Heart failure and atrial fibrillation. Atrioventricular node ablation and cardiac resynchronization therapy (CRT) vs. Medical therapy (rate or rhythm control) was evaluated. Atrioventricular node ablation combined with cardiac resynchronization therapy is an effective definitive solution for patients with heart failure and atrial fibrillation refractory to medical therapy.
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