Why the study?
Does atrioventricular junctional ablation with DDDR pacemaker implantation improve symptoms and quality of life compared to pharmacological treatment in patients with drug-resistant paroxysmal atrial fibrillation?
Does atrioventricular junctional ablation with DDDR pacemaker implantation improve symptoms and quality of life compared to pharmacological treatment in patients with drug-resistant paroxysmal atrial fibrillation?
Atrioventricular junctional ablation with DDDR pacemaker implantation is superior to medical therapy for symptom control and quality of life in drug-resistant paroxysmal atrial fibrillation, despite a risk of progression to permanent atrial fibrillation.
AV junction ablation plus pacemaker offers superior symptom control over drugs in refractory paroxysmal AF; extends RCT evidence on QoL gains despite progression risk.
We performed a prospective randomized 6-month evaluation of the clinical effects of atrioventricular junctional ablation together with placement of a DDDR mode-switching pacemaker vs pharmacological treatment in 43 patients with intolerable paroxysmal atrial fibrillation not controlled with antiarrhythmic drugs. Ablation and pacemaker treatment were highly effective and superior to drug therapy in controlling symptoms and improving quality of life. However, discontinuation of drug therapy exposed patients to further recurrences of paroxysmal atrial fibrillation and the risk of developing permanent atrial fibrillation.
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Brignole et al. (1999) studied this question.
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