Key result
Atrioventricular junction ablation in patients with atrial fibrillation undergoing CRT is often required to achieve 100% biventricular pacing, improving global cardiac function and survival.
Why the study?
Does atrioventricular junction ablation improve global cardiac function and survival in heart failure patients with atrial fibrillation undergoing CRT?
Does atrioventricular junction ablation improve global cardiac function and survival in heart failure patients with atrial fibrillation undergoing CRT?
Atrioventricular junction ablation is a crucial strategy to ensure 100% biventricular pacing and improve outcomes in patients with heart failure and atrial fibrillation undergoing CRT.
Supports targeting maximal BiV pacing during CRT; leaves open optimal thresholds and hard-endpoint confirmation in prospective trials.
PURPOSE OF REVIEW: Atrial fibrillation and heart failure are commonly encountered in current clinical practice. This review aims to revisit the complex interaction of these two common situations and the best treatment whenever both occurs, especially focusing on heart failure patients undergoing cardiac resynchronization therapy (CRT). RECENT FINDINGS: It has been recently confirmed that in patients undergoing cardiac resynchronization therapy, 100% biventricular pacing percentage should be pursued. Large observational studies confirmed that atrioventricular junction ablation is very often the only way to gain 100% biventricular pacing in atrial fibrillation. SUMMARY: On the basis of the recent observational extensive data, in patients presenting intermediate or elevated atrial tachycardia-atrial fibrillation burden, atrioventricular junction ablation may represent a fundamental tool to achieve full CRT delivery, thus, conferring marked improvements in global cardiac function, and by extension, in survival. Atrial fibrillation patients should not be excluded from CRT, provided that maximal biventricular pacing is warranted.
No takes yet. Share an insight, caveat, or question.
Gasparini et al. (2017) conducted a review in Atrial fibrillation and heart failure. Atrioventricular junction ablation was evaluated. Atrioventricular junction ablation in patients with atrial fibrillation undergoing CRT is often required to achieve 100% biventricular pacing, improving global cardiac function and survival.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: