Key result
AV node ablation with CRT-D improves LVEF by ~15 points at 3 months in persistent AF.
Why the study?
Persistent atrial fibrillation and frequent premature ventricular complexes may contribute to worsening heart failure, particularly when malignancy limits guideline-directed medical therapy.
Does atrioventricular nodal ablation with cardiac resynchronization therapy-defibrillator implantation improve ventricular rate control and left ventricular ejection fraction in a patient with HFrEF, persistent atrial fibrillation, frequent premature ventricular complexes, and malignancy-related limitations to guideline-directed medical therapy?
Case Report (n=1)
No
Does atrioventricular nodal ablation with cardiac resynchronization therapy-defibrillator implantation improve ventricular rate control and left ventricular ejection fraction in a patient with HFrEF, persistent atrial fibrillation, frequent premature ventricular complexes, and malignancy-related limitations to guideline-directed medical therapy?
In a patient with HFrEF, persistent atrial fibrillation, frequent PVCs, and active malignancy limiting guideline-directed medical therapy, atrioventricular nodal ablation with CRT-D implantation achieved durable rate control and improved LVEF from 20%–25% to 35%–40% at 3 months.
Persistent atrial fibrillation and frequent premature ventricular complexes may contribute to worsening heart failure, particularly when malignancy limits guideline‐directed medical therapy. In patients with progressive ventricular dysfunction and limited pharmacologic options, atrioventricular nodal ablation with cardiac resynchronization therapy‐defibrillator implantation may provide durable rate control and support subsequent ventricular functional recovery.
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Roger et al. (2026) conducted a case report in Heart failure with reduced ejection fraction (HFrEF) with persistent atrial fibrillation, frequent premature ventricular complexes, and metastatic prostate cancer (n=1). Atrioventricular nodal ablation with cardiac resynchronization therapy-defibrillator (CRT-D) implantation was evaluated on Left ventricular ejection fraction (LVEF) at 3 months. Atrioventricular nodal ablation with CRT-D implantation improved left ventricular ejection fraction from 20%–25% to 35%–40% at 3 months in a 76-year-old man with persistent AF and HFrEF.
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