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Updated: Jul 19, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Atrioventricular junction ablation followed by resynchronization therapy in patients with congestive heart failure

Mohamed H Hamdan1, Roger A Freedman, Edward M Gilbert

  • 1Department of Internal Medicine, Division of Cardiology, University of Utah Health Sciences Center, Salt Lake City, Utah 84132-2401, USA. mohamed.hamdan@hsc.utah.edu

Pacing and Clinical Electrophysiology : PACE
|October 14, 2006
PubMed

Insights

Atrial fibrillation (AF) and heart failure (CHF) impact millions. Biventricular pacing after AV junction ablation may improve exercise capacity in CHF patients with AF, unlike RV pacing.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Atrial fibrillation (AF) and congestive heart failure (CHF) are prevalent cardiovascular conditions.
  • Irregular ventricular response in AF may contribute to left ventricular dysfunction.
  • Previous studies comparing pharmacologic rate control to AV junction ablation with RV pacing showed no improvement.

Purpose of the Study:

  • To test if AV junction ablation followed by biventricular pacing improves exercise capacity and functional status in CHF patients with AF.
  • To compare biventricular pacing against pharmacologic rate control.
  • To evaluate outcomes regardless of rate or QRS duration in patients with chronic AF and reduced ejection fraction.

Main Methods:

  • A prospective, randomized, double-blinded, multicenter trial (AVERT-AF).
  • Enrollment of 180 patients with chronic AF and depressed ejection fraction.
  • Primary endpoint: exercise duration.

Main Results:

  • The study hypothesizes that AVJ ablation with biventricular pacing significantly improves exercise capacity.
  • This approach aims to overcome the limitations of RV apical pacing after AVJ ablation.
  • Results are expected to guide treatment for AF in patients with left ventricular dysfunction.

Conclusions:

  • The AVERT-AF trial will provide crucial data on optimal management strategies.
  • Findings will help define the best treatment for this common arrhythmia in patients with left ventricular dysfunction.
  • This research addresses a significant unmet need in cardiovascular medicine.

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