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AV nodal ablation and pacemaker implantation improves hemodynamic function in atrial fibrillation
Yoshihide Takahashi1, Iesaka Yoshito, Atsushi Takahashi
1Cardiovascular Division, Tsuchiura Kyoudo Hospital, Tokyo, Japan. yoshit@tf6.so-net.ne.jp
Pacing and Clinical Electrophysiology : PACE
|May 27, 2003
Summary
Ablation and pacing therapy (APT) significantly improved quality of life and cardiac function in atrial fibrillation (AF) patients. Plasma BNP levels effectively predict optimal candidates for this effective AF treatment.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Atrial fibrillation (AF) poses significant challenges for patients with drug-refractory symptoms.
- Hemodynamic assessment is crucial for evaluating treatment efficacy in AF management.
Purpose of the Study:
- To evaluate the hemodynamic effects of AV node ablation and pacing therapy (APT) in drug-refractory, symptomatic AF patients.
- To assess improvements in quality of life, cardiac performance, and neurohormone levels post-APT.
Main Methods:
- Thirty-eight patients with symptomatic AF underwent APT across eight Japanese centers.
- Outcomes were measured using quality-of-life questionnaires, echocardiography (ejection fraction), and plasma ANP/BNP levels pre- and post-therapy.
Main Results:
- Significant improvements were observed in quality of life (WHO QOL 26, Symptom Checklist) and ejection fraction within 6 months and 1 week post-APT, respectively.
- Plasma ANP and BNP levels decreased significantly 1 month after APT in patients with elevated baseline levels.
- Elevated baseline plasma BNP levels predicted optimal response to APT.
Conclusions:
- APT demonstrates beneficial hemodynamic effects in drug-refractory, symptomatic AF patients.
- Plasma BNP levels serve as a predictive biomarker for identifying patients who will benefit most from APT.