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Predictors of hospitalization for heart failure and of all-cause mortality after atrioventricular nodal ablation and right ventricular pacing for atrial fibrillation
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
Clinical Epidemiology and Biostatistics Unit, Örebro University Hospital, Örebro, Sweden.
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2014 (English)In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 16, no 12, 1772-1778 p.Article in journal (Refereed) Published
Abstract [en]

Aims: Atrioventricular junction ablation (AVJA) is a highly effective treatment in patients with therapy refractory atrial fibrillation (AF) but renders the patient pacemaker dependent. We aimed to analyse the long-term incidence of hospitalization for heart failure (HF) and all-cause mortality in patients who underwent AVJA because of AF and to determine predictors for HF and mortality.

Methods and results: We retrospectively enrolled 162 consecutive patients, mean age 67 +/- 9 years, 48% women, who underwent AVJA because of symptomatic AF refractory to pharmacological treatment (n = 117) or unsuccessful repeated pulmonary vein isolation (n = 45). Hospitalization for HF occurred in 32 (20%) patients and 35 (22%) patients died, representing a cumulative incidence for hospitalization for HF and mortality over the first 2 years after AVJA of 9.1 and 5.2%, respectively. Hospitalization for HF occurred to the same extent in patients who failed pharmacological treatment as in patients with repeated pulmonary vein isolation (PVI), although the mortality was slightly higher in the former group. QRS prolongation >= 120 ms and left atrial diameter were independent predictors of hospitalization for HF, while hypertension and previous HF were independent predictors of death.

Conclusion: The long-term hospitalization rate for HF and all-cause mortality was low, which implies that long-term ventricular pacing was not harmful in this patient population, including patients with unsuccessful repeated PVI.

Place, publisher, year, edition, pages
Oxford University Press, 2014. Vol. 16, no 12, 1772-1778 p.
Keyword [en]
Atrial fibrillation, Atrioventricular junction ablation, Heart failure, Hospitalization, Mortality
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
URN: urn:nbn:se:oru:diva-42367DOI: 10.1093/europace/euu171ISI: 000347104900016PubMedID: 25031234OAI: oai:DiVA.org:oru-42367DiVA: diva2:785867
Note

Funding Agency:

Örebro Heart Foundation

Research Committee of Örebro University Hospital

Available from: 2015-02-04 Created: 2015-02-03 Last updated: 2017-10-18Bibliographically approved

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