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1. Atrioventricular junctional ablation: The good, the bad, the better

Author

Benjamin J. Scherlag, PhD, FHRS, Khaled Elkholey, MD, Stavros Stavrakis, MD, PhD, Warren M. Jackman, MD, FHRS, and Sunny S. Po, MD, PhD, FHRS

Subjects
Atrial fibrillation, Atrioventricular junction, AV node, Catheter ablation, Fast pathway, His bundle pacing, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: The management of patients with atrial fibrillation and an abnormally fast ventricular response has been through the use of pharmacologic agents. In those cases where rate control cannot be achieved pharmacologically, a standard approach has been atrioventricular (AV) junctional ablation and ventricular pacemaker implantation to achieve a stable ventricular rate. Long-term ventricular pacing has been shown to result in diminished ventricular function that can lead to heart failure. Objective: To describe an experimental and clinical study demonstrating a modified form of AV junction ablation. Methods: Ablation of the slow and fast AV nodal input does not produce AV block. Ablation of the connection between the two induces AV block, leaving the AV node and His bundle intact. Results: Subsequently the escape heart rate is close to normal and responds well to exercise. Conclusion: In a clinical study with a 42 month follow-up, the modified procedure resulted in significantly reduced pacemaker dependence and mortality compared to the standard AV ablation procedure.

Published
2020
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2. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary

Author

Hugh Calkins, MD, Gerhard Hindricks, MD, Riccardo Cappato, MD, Young-Hoon Kim, MD, PhD, Eduardo B. Saad, MD, PhD, Luis Aguinaga, MD, PhD, Joseph G. Akar, MD, PhD, Vinay Badhwar, MD, Josep Brugada, MD, PhD, John Camm, MD, Peng-Sheng Chen, MD, Shih-Ann Chen, MD, Mina K. Chung, MD, Jens Cosedis Nielsen, DMSc, PhD, Anne B. Curtis, MD, D. Wyn Davies, MD, John D. Day, MD, André d’Avila, MD, PhD, N.M.S. (Natasja) de Groot, MD, PhD, Luigi Di Biase, MD, PhD, Mattias Duytschaever, MD, PhD, James R. Edgerton, MD, Kenneth A. Ellenbogen, MD, Patrick T. Ellinor, MD, PhD, Sabine Ernst, MD, PhD, Guilherme Fenelon, MD, PhD, Edward P. Gerstenfeld, MS, MD, David E. Haines, MD, Michel Haissaguerre, MD, Robert H. Helm, MD, Elaine Hylek, MD, MPH, Warren M. Jackman, MD, Jose Jalife, MD, Jonathan M. Kalman, MBBS, PhD, Josef Kautzner, MD, PhD, Hans Kottkamp, MD, Karl Heinz Kuck, MD, PhD, Koichiro Kumagai, MD, PhD, Richard Lee, MD, MBA, Thorsten Lewalter, MD, PhD, Bruce D. Lindsay, MD, Laurent Macle, MD, Moussa Mansour, MD, Francis E. Marchlinski, MD, Gregory F. Michaud, MD, Hiroshi Nakagawa, MD, PhD, Andrea Natale, MD, Stanley Nattel, MD, Ken Okumura, MD, PhD, Douglas Packer, MD, Evgeny Pokushalov, MD, PhD, Matthew R. Reynolds, MD, MSc, Prashanthan Sanders, MBBS, PhD, Mauricio Scanavacca, MD, PhD, Richard Schilling, MD, Claudio Tondo, MD, PhD, Hsuan-Ming Tsao, MD, Atul Verma, MD, David J. Wilber, MD, and Teiichi Yamane, MD, PhD

Subjects
Ablation, Arrhythmia, Atrial fibrillation, Atrial flutter, Atrial tachycardia, Catheter ablation, Surgical ablation, Stroke, Anticoagulation, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2017
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