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- Title
Long-Term Follow-Up After Atrioventricular Nodal Ablation and Pacing: Low Incidence of Sudden Cardiac Death.
- Authors
Gasparini, Maurizio; Mantica, Massimo; Brignole, Michele; Coltorti, Fernando; Galimberti, Paola; Giafranchi, Lorella; Menozzi, Carlo; Magenta, Giovanni; Delise, Pietro; Proclemer, Alessandro; Tognarini, Stefano; Ometto, Renato; Acquati, Fabrizio; Mantovan, Roberto
- Abstract
Sudden cardiac death (SCD) has been reported in patients with drug refractory AF who underwent AV nodal ablation and pacing. However, whether SCD in these patients is related to the underlying heart disease or to the ablating and pacing procedure remains uncertain. Between May 1987 and January 1997, AV nodal ablation was performed in 585 patients (mean age 66 ± 11 years) with drug-resistant, paroxysmal (n = 308) or chronic (n = 277) AF in 12 Italian centers. Lone AF was present in 133 patients. After AV junction oblation, patients underwent VVIR (454 patients) or DDDR (131 patients) pacemaker implantation. At a follow-up of 33.6 ± 24.2 months, 80 (13.7%) deaths were recorded: 40 noncardiac, 23 nonsudden, and 17 sudden cardiac death (3%, 1.04% per year). Among five variables, including age, NYHA functional class, presence of heart disease, paroxysmal or chronic AF, previous embolic events, and LVEF, the presence of heart disease (P = 0.007) and a LVEF < 0.45, (P = 0.003) were associated with a higher risk of SCD. Analysis of SCD-free survival by log-rank test showed a higher incidence of SCD in patients with LVEF < 0.45 (P = 0.0001) and with coronary artery disease (P = 0.005). In this large cohort, a low incidence of long-term SCD after A V nodal ablation and pacing for drug-refractory AF was observed. The presence of underlying heart disease an d the extent of baseline LV dysfunction were associated with an increased likelihood of SCD.
- Subjects
CARDIAC arrest; ATRIAL fibrillation; HEART diseases; CARDIAC pacing; CARDIAC pacemakers; IMPLANTED cardiovascular instruments
- Publication
Pacing & Clinical Electrophysiology, 2000, Vol 23, Issue 11, p1925
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.2000.tb07054.x