AV node ablation outcomes study
Acute and long-term outcomes of AV node ablation
Liverpool Heart and Chest Hospital, R&D Department
Duration of Study in the UK
1 years, 0 months, 1 days
Background: AV node ablation and pacing therapy (“pace and ablate”) is superior to standard medical therapy for controlling heart rate in atrial fibrillation (Afib) and is associated with improvement of symptoms, quality of life, and cardiac function.1–4 Right ventricular (RV) pacing induced cardiomyopathy is common among patients undergoing AV node ablation without cardiac resynchronisation therapy.4,5 There is only limited data on the optimal patient selection for pace and ablate therapy and prevention of long-term complications of this therapy is challenging.
Aim: This analysis will be conducted to evaluate the outcomes of pace and ablate therapy in a large, single-centre study.
Methodology: This is a retrospective single-centre study designed to assess the outcomes of a large sample of patients undergoing pace and ablate therapy. The primary endpoint will be identifying independent predictors for developing RV pacing induced cardiomyopathy in patients with non-CRT cardiovascular implantable electronic devices (CIED) and developing a predictive score. Secondary endpoints include 1) Acute and long-term complications following AV node ablation including acute heart failure (AHF) hospitalisations. 2) Comparison of baseline and procedural characteristics of CRT and non-CRT patients undergoing AV node ablation. 2) Comparison of baseline and procedural characteristics of AV node ablation in non-CRT patients with vs without RV pacing induced cardiomyopathy and/or AHF hospitalizations on follow-up 3) Improvement of LVEF in CRT patients undergoing AV node ablation 4) Change in arrhythmia symptoms in patients undergoing AV node ablation as quantified by EHRA class 5) Change in heart failure symptoms in patients undergoing AV node ablation as quantified by NYHA class.
Potential significance: This study aims to improve patent selection for pace and ablate therapy including the decision for CRT vs non-CRT device prior to the ablation.