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Long-Term Outcomes of Radiofrequency Atrioventricular Node Ablation in a Real-World Population
Vanessa Sciacca1, Nora-Kristin Brandt1, Thomas Fink1
1Clinic For Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Background:
While interventional strategies have expanded the options for long term rhythm restoration, rate control continues to play a pivotal role in the treatment of atrial arrhythmias; however, pharmacologic strategies alone often fail in achieving effective rate control.
Aims:
To examine long-term outcomes in patients who have undergone atrioventricular node ablation (AVNA) for the management of symptomatic atrial arrhythmias.
Methods:
This observational Study Assessed Patients Who Underwent AVNA For Rate Control of Atrial Fibrillation (AF) Or Atrial Tachycardia (AT) Between April 2014 and February 2022. Clinical data, along with follow-up information including cardiac device interrogation were analyzed. A composite safety endpoint, Encompassing Heart Failure (HF) Rehospitalization, lead revision, device infection, or upgrade for cardiac resynchronization therapy (CRT), was evaluated. Additionally, structured patient interviews were conducted to assess quality of life outcomes.
Results:
192 patients (76 females (39.6%), mean age 73.7 ± 10 years) were included into the study. Patients suffered from paroxysmal AF in 10 cases (5.2%), persistent AF in 138 cases (71.9%) and AT in 44 cases (22.9%). Acute AVNA was successful in all patients. Two pseudoaneurysms at the femoral puncture site occurred as the only periprocedural complications. Mean follow-up duration was 907.0 ± 609.7 days. Persistent complete AV block was present in 191 patients (99.5%) during follow-up. The composite safety endpoint occurred in 58 (30.2%) patients. Quality of life significantly improved in most patients with a relevant regression in EHRA and NYHA scores.
Conclusion:
AVNA is effective and safe in an all-comer patient population with high success rates in terms of rate control, QOL improvement and a favorable safety profile during long-term observation.
