Original Article
Long-Term Survival after Ablation of the Atrioventricular Node and Implantation of a Permanent Pacemaker in Patients with Atrial Fibrillation
N Engl J Med 2001; 344:1043-1051April 5, 2001
- Abstract
Background
In patients with atrial fibrillation that is refractory to drug therapy, radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker are an alternative therapeutic approach. The effect of this procedure on long-term survival is unknown.
Methods
We studied all patients who underwent ablation of the atrioventricular node and implantation of a permanent pacemaker at the Mayo Clinic between 1990 and 1998. Observed survival was compared with the survival rates in two control populations: age- and sex-matched members of the Minnesota population between 1970 and 1990 and consecutive patients with atrial fibrillation who received drug therapy in 1993.
Results
A total of 350 patients (mean [±SD] age, 68±11 years) were studied. During a mean of 36±26 months of follow-up, 78 patients died. The observed survival rate was significantly lower than the expected survival rate based on the general Minnesota population (P<0.001). Previous myocardial infarction (P< 0.001), a history of congestive heart failure (P=0.02), and treatment with cardiac drugs after ablation (P= 0.03) were independent predictors of death. Observed survival among patients without these three risk factors was similar to expected survival (P=0.43). None of the 26 patients with lone atrial fibrillation died during follow-up (37±27 months). The observed survival rate among patients who underwent ablation was similar to that among 229 controls with atrial fibrillation (mean age, 67±12 years) who received drug therapy (P=0.44).
Conclusions
In the absence of underlying heart disease, survival among patients with atrial fibrillation after ablation of the atrioventricular node is similar to expected survival in the general population. Long-term survival is similar for patients with atrial fibrillation, whether they receive ablation or drug therapy. Control of the ventricular rate by ablation of the atrioventricular node and permanent pacing does not adversely affect long-term survival.
Media in This Article
Figure 1
Observed Survival among Patients Who Underwent Ablation of the Atrioventricular Node and among Controls Treated with Drugs for Atrial Fibrillation, and Expected Survival Rates Based on Mortality in an Age- and Sex-Matched General Population.Figure 3
Observed Survival among 121 Patients Who Underwent Ablation of the Atrioventricular Node and Implantation of a Permanent Pacemaker for Atrial Fibrillation but Who Had No History of Congestive Heart Failure or Myocardial Infarction and No Cardiac-Drug Use after Ablation, as Compared with the Expected Survival Based on Mortality in an Age- and Sex-Matched Control Population.Article Activity
- Article
Atrial fibrillation is associated with increased morbidity and mortality1-5 and is an independent risk factor for stroke.6,7 Although the association between atrial fibrillation and mortality has been debated, a recent report showed that atrial fibrillation was associated with a mortality rate that was higher by a factor of 1.5 to 1.9 than the rate expected in the general population, after adjustment for other cardiovascular conditions.1
The optimal goal in treating atrial fibrillation is to restore and maintain sinus rhythm — often a formidable task. Despite therapy with antiarrhythmic drugs, studies have reported recurrence rates of 50 to 60 percent during a mean follow-up of one to two years.8-12 In patients with severe symptoms in whom drug therapy fails, ablation of the atrioventricular node and permanent pacing are effective in controlling the ventricular rate.13-16 Although ablation of the atrioventricular node does not eliminate atrial fibrillation, it alleviates symptoms and improves the quality of life, exercise tolerance, and left ventricular function.17-20 Despite the effectiveness of this treatment in relieving symptoms, its effect on long-term survival in patients with severe symptoms in whom drug therapy has failed is unknown. The potentially deleterious effect on survival of the creation of permanent atrioventricular block and the resulting lifelong commitment to the use of a pacemaker is a serious concern.
We assessed long-term survival and predictors of death after the ablation of the atrioventricular node and the implantation of a permanent pacemaker in 350 patients with atrial fibrillation. To test the hypothesis that this treatment has an adverse effect on long-term survival, we compared the observed survival with expected survival calculated on the basis of age- and sex-specific mortality rates in the Minnesota population and with the observed survival of a group of consecutive patients who received pharmacologic therapy for atrial fibrillation.
Methods
Study Population
All patients with atrial fibrillation who underwent radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker at the Mayo Clinic between July 1990 and December 1998 were included in the study. Patients with indications for ablation were those with symptomatic paroxysmal or chronic atrial fibrillation that was refractory to drug therapy aimed at controlling the ventricular rate or maintaining sinus rhythm. None of the 350 patients we studied underwent direct-current ablation. The potential risks of the procedure were explained, and oral informed consent was obtained from all patients.
Control Groups
The first control group was constructed on the basis of the age and sex of all patients who underwent ablation, and the expected survival rate was calculated on the basis of age- and sex-specific mortality rates in the Minnesota population for the period between 1970 and 1990.21 We assumed that the expected survival rate accounts for the effects of cardiovascular and other medical conditions according to their known prevalence in the reference population.
The second control group was selected from a group of consecutive patients who received drug therapy for atrial fibrillation at the Mayo Clinic in 1993. These patients were selected from an existing data base as members of the control group because they had clinical characteristics and follow-up that were similar, although not identical, to those of the patients who underwent ablation.
Data Collection
Data were collected from a centralized system that contained complete records of all patients treated and followed at the Mayo Clinic and its hospitals. These records provide a detailed history and diagnosis for all outpatient encounters, including emergency room visits and home and nursing home visits, as well as data recorded during inpatient care, death certificates, and autopsy reports.
Follow-up
The follow-up period for the patients who underwent ablation began at the time of the procedure; the follow-up period for the controls treated with drugs began in 1993. For both groups, follow-up ended in January 1999 or at the time of death. Patients who underwent ablation had follow-up visits in the pacemaker clinic every three months for the first year and were surveyed annually thereafter. Causes of death were determined by a review of hospital records and death certificates and by telephone interviews of local physicians or family members. All patients in both groups who entered the study had at least one follow-up visit.
Atrioventricular-Node Ablation and Pacemaker Implantation
Radio-frequency ablation of the atrioventricular node was performed by standard techniques.22,23 Complete atrioventricular block was achieved in all patients. Seven patients (2 percent of those enrolled) required a left-sided approach to achieve complete block, and 24 patients (7 percent) required a second or third procedure because of recurrent atrioventricular conduction after the first attempt.
A rate-responsive ventricular pacemaker was implanted if the patient was in atrial fibrillation at the time of the procedure and if attempts to restore and maintain sinus rhythm by means of cardioversion were not performed. A dual-chamber, rate-adaptive pacemaker was implanted if the patient was in sinus rhythm at the time of the procedure.
Statistical Analysis
Survival of the patients who underwent ablation and the controls treated with drugs was estimated by the Kaplan–Meier method. For each person who underwent ablation, the expected survival was calculated on the basis of age- and sex-specific mortality rates in the Minnesota population during the period between 1970 and 1990.21 The observed and expected survival rates were compared by means of the one-sample log-rank test.24 All three survival curves were compared by means of the two-sample log-rank test. Categorical variables were compared between groups with use of the chi-square test for independence. Continuous variables were compared with the use of the Wilcoxon rank-sum test. Univariate and multivariate associations between base-line variables and survival were assessed by means of the log-rank test and a Cox regression model.25 The following variables were considered as potential prognostic factors: demographic features (age and sex), clinical history (syncope, angina, and congestive heart failure), and the presence of heart disease (ischemic heart disease, cardiomyopathy, and valvular heart disease) and associated clinical conditions (diabetes mellitus, chronic obstructive pulmonary disease, cerebrovascular disease, hypertension, and cancer). Treatment with cardiac medications after ablation was also included as a variable in the analysis. Multivariate models are presented in the form of point estimates of the risk ratios, with 95 percent confidence intervals.
Results
Demographic Characteristics
A total of 350 patients with atrial fibrillation (185 men and 165 women) who underwent ablation and had a pacemaker implanted at the Mayo Clinic between 1990 and 1998 were included in the study. A single-chamber ventricular pacemaker was implanted in 55 percent of the patients, and a dual-chamber pacemaker in 45 percent.
The base-line characteristics of the patients who underwent ablation are summarized in Table 1Table 1
Base-Line Characteristics of Patients with Atrial Fibrillation Who Underwent Ablation of the Atrioventricular Node and Implantation of a Pacemaker between 1990 and 1998.. Drugs used to control the ventricular rate or to maintain sinus rhythm before ablation included digoxin (used by 87 percent of patients), a calcium-channel blocker (82 percent), a beta-blocker (56 percent), quinidine (43 percent), procainamide (30 percent), disopyramide (18 percent), propafenone (47 percent), flecainide (20 percent), encainide (6 percent), sotalol (13 percent), and amiodarone (41 percent). After ablation, 188 patients (54 percent) continued to take one or more cardiac drugs because of preexisting cardiovascular disease. These drugs included digoxin, calcium-channel blockers, beta-blockers, angiotensin-converting–enzyme inhibitors, nitrates, diuretics, and antiarrhythmic agents (propafenone, sotalol, amiodarone, and mexiletine). At the time of the ablation, 11 percent of patients were in New York Heart Association functional class III or IV, and 37 percent had a reduced left ventricular ejection fraction (a fraction of 40 percent or lower).Sixty-eight patients (19 percent) had a history of a cerebrovascular accident or transient ischemic attack, and eight patients (2 percent) had peripheral arterial embolism before ablation. During follow-up, a cerebrovascular accident or transient ischemic attack occurred in 15 patients (of whom 6 [40 percent] had had a previous such event), and 3 had peripheral arterial embolism. At the time of embolic complications, all patients except one were receiving warfarin therapy. The mean (±SD) international normalized ratio was 2.1±1.0 (range, 1.0 to 4.5) immediately before the thromboembolic event. The clinical characteristics of the patients who underwent ablation and the controls treated with drugs are summarized in Table 2Table 2
Clinical Characteristics of the Patients Who Underwent Ablation at the Time of the Procedure and of the Controls Treated with Drugs at the Time of In-Hospital Therapy..Overall Survival
The observed survival among the patients who underwent ablation is shown in Figure 1AFigure 1
Observed Survival among Patients Who Underwent Ablation of the Atrioventricular Node and among Controls Treated with Drugs for Atrial Fibrillation, and Expected Survival Rates Based on Mortality in an Age- and Sex-Matched General Population., along with the expected survival for age- and sex-matched members of the Minnesota population. The observed survival was significantly worse than the expected survival (P<0.001). The survival curve of the controls treated with drugs is also shown in Figure 1A. The observed survival rates of the patients who underwent ablation and the controls treated with drugs were not significantly different (P=0.44; risk ratio for the ablation group as compared with the controls, 1.14; 95 percent confidence interval, 0.81 to 1.60).Overall Survival with Coexisting Heart Disease
In subgroup analyses, the survival rate among 115 patients with atrial fibrillation and congestive heart failure who underwent ablation was compared with that among 58 controls with the same indications who were treated with drugs (Figure 1B). The difference in survival between the groups was not significant (P= 0.75; risk ratio, 1.09; 95 percent confidence interval, 0.66 to 1.79). Survival was similar for 156 patients with coronary artery disease who underwent ablation and 83 controls with coronary artery disease who were treated with drugs (P=0.85; risk ratio, 0.96; 95 percent confidence interval, 0.60 to 1.52) (Figure 1C). When patients with a history of congestive heart failure and previous myocardial infarction were excluded from the analysis, survival among the 194 patients who underwent ablation was similar to that among the 144 controls who were treated with drugs (P= 0.13; risk ratio, 1.57; 95 percent confidence interval, 0.88 to 2.81).
Univariate and multivariate predictors of death, with associated risk ratios, 95 percent confidence intervals, and P values, are summarized in Table 3Table 3
Predictors of Death in Patients with Atrial Fibrillation after Ablation of the Atrioventricular Node and Permanent Pacing.. Multivariate analysis showed that previous myocardial infarction (P<0.001), a history of congestive heart failure (P=0.02), and use of cardiac drugs after the ablation (P=0.03) were independent predictors of death (Table 3). Cumulative survival rates were significantly worse than expected survival rates for patients who had a history of myocardial infarction or congestive heart failure or who received cardiac-drug therapy after ablation (Figure 2Figure 2
Cumulative Survival for Subgroups of Patients Who Underwent Ablation of the Atrioventricular Node and Implantation of a Permanent Pacemaker between 1990 and 1998 and Expected Survival Based on Mortality among Age- and Sex-Matched Controls.). The observed survival rates among patients without a history of myocardial infarction were not significantly different from the expected survival rates (P=0.07); the same was true for those who did not receive cardiac-drug therapy after ablation (P=0.32). The observed survival among patients without congestive heart failure was worse than the expected survival rate (P=0.05), but 17 percent of the patients with a history of congestive heart failure also had a history of myocardial infarction, and 42 percent of the patients with a history of congestive heart failure were taking cardiac drugs after ablation. For the 121 patients without any of the three independent risk factors, the observed survival was similar to the expected survival (P=0.43) (Figure 3Figure 3Observed Survival among 121 Patients Who Underwent Ablation of the Atrioventricular Node and Implantation of a Permanent Pacemaker for Atrial Fibrillation but Who Had No History of Congestive Heart Failure or Myocardial Infarction and No Cardiac-Drug Use after Ablation, as Compared with the Expected Survival Based on Mortality in an Age- and Sex-Matched Control Population.).Lone Atrial Fibrillation
In our study, patients were considered to have lone atrial fibrillation if they did not have ischemic heart disease, hyperthyroidism, congestive heart failure, cardiomyopathy, hypertension, chronic obstructive pulmonary disease, previous cardiac surgery, or potentially life-shortening noncardiac disease (diabetes or cancer). There was no age restriction. Twenty-six patients met the criteria for lone atrial fibrillation (14 men and 12 women; mean age, 64±13 years; range, 41 to 83 years); none of them died during a mean follow-up period of 37±27 months.
Mortality and Causes of Death
At the latest assessment, 78 patients had died (mean follow-up, 27±25 months; range, 3 days to 88 months) (Table 1). Their mean age at the time of ablation was 69±10 years (range, 39 to 95). The causes of death are summarized in Table 4Table 4
Primary Causes of Death among Patients Who Underwent Ablation of the Atrioventricular Node and Permanent Pacing for Atrial Fibrillation..Discussion
In this long-term follow-up study, we assessed the survival of patients who presented with symptomatic atrial fibrillation that was refractory to medical therapy and who then underwent ablation of the atrioventricular node and implantation of a permanent pacemaker. Among the patients who underwent ablation, the observed overall survival was significantly worse than the expected survival for age- and sex-matched members of the Minnesota population. The observed survival among patients who underwent ablation for atrial fibrillation was similar to that among controls treated with drugs for atrial fibrillation. In the absence of previous myocardial infarction, previous congestive heart failure, and treatment with cardiac medications after ablation, the observed survival among patients who underwent ablation was similar to the expected survival for age- and sex-matched members of the Minnesota population. None of the 26 patients with lone atrial fibrillation died during a mean follow-up period of 37±27 months.
Our observations confirm that the presence of preexisting cardiac disease is the main determinant of long-term survival in patients with atrial fibrillation who undergo ablation of the atrioventricular node. More important, the normal survival rate among patients without clinically significant heart disease, the excellent survival rate among patients with lone atrial fibrillation, and the similar survival rates for the patients who underwent ablation and the controls with atrial fibrillation who were treated with drugs suggest that controlling the ventricular rate and alleviating symptoms by ablation of the atrioventricular node and permanent pacing do not have an adverse effect on long-term survival in this patient population.
Survival data from epidemiologic studies have demonstrated higher mortality among patients with atrial fibrillation than among patients in sinus rhythm.1,2,4,26-28 Data from the Framingham Heart Study showed that the risk-factor–adjusted odds ratio for mortality was 1.5 for men and 1.9 for women with atrial fibrillation, as compared with subjects in sinus rhythm.1 In some patients, atrial fibrillation may be a marker of atherosclerosis, older age, and loss of vascular compliance (all of which could be associated with a higher risk of stroke and death); nevertheless, the evidence supports the conclusion that atrial fibrillation is an independent predictor of poor long-term survival.
Results from observational studies17-20 and randomized trials29,30 have demonstrated that ablation of the atrioventricular node and permanent pacing are effective in controlling the ventricular rate, alleviating symptoms, and improving the quality of life, exercise tolerance, and left ventricular function. However, there is concern that the creation of complete atrioventricular block that is inherent in this approach and the requirement for permanent pacing to which it leads may have an adverse effect on survival. According to the Framingham Heart Study, overall mortality for men between 65 and 74 years old is 20.8 percent at one year and 48.2 percent at five years; for women in the same age group, overall mortality is 18.2 percent at one year and 38.9 percent at five years.1 The mean age of our study population was 68±11 years, and overall mortality was 8 percent at one year and 27 percent at five years; these rates compare favorably with those in the Framingham Heart Study, in which most cases of atrial fibrillation were managed medically. Although direct comparisons cannot be made between our data and data from the Framingham Heart Study, because of differences in the study populations, the methods of analysis, and the timing of the studies, it is encouraging to note that overall mortality was lower among the patients in our study who underwent ablation of the atrioventricular node and permanent pacing than it was among patients in the Framingham Heart Study.
The safety of ablation for controlling the ventricular rate is confirmed by the similar long-term survival in a group of consecutive patients receiving medical treatment for atrial fibrillation. Because the controls who were treated with drugs were identified retrospectively, the clinical characteristics of the two groups are not identical, but the survival rate in this group was similar to that among patients who underwent ablation, despite the fact that the ablation group had higher proportions of men, of patients with myocardial infarction and hypertension, and of patients in whom previous drug treatment had failed.
Our study confirmed that preexisting cardiovascular disease and coexisting medical conditions are predictors of a higher risk of death in patients with atrial fibrillation. The mode of pacing and the type of atrial fibrillation (chronic or paroxysmal) were not independent predictors of long-term survival. The observation that survival was normal among patients without a history of myocardial infarction or congestive heart failure who were not taking cardiac medications after ablation suggests that in addition to having beneficial effects on symptoms, as demonstrated by other studies, this therapy is unlikely to have a negative effect on long-term survival. The observation of similar rates of survival in subgroups of patients with coronary artery disease or congestive heart failure whether they were treated medically or with ablation indicates that ablation of the atrioventricular node is as safe as conventional medical treatment for atrial fibrillation in patients with underlying heart disease.
The clinical features of patients with lone atrial fibrillation have been highlighted by epidemiologic studies such as the Framingham Heart Study31 and a study from Olmsted County, Minnesota,32 which found a low risk of stroke and a low rate of mortality overall. In our study, the indications in 26 patients (7 percent) met the definition of lone atrial fibrillation, and none of them had died by the end of the study, further supporting the conclusion that ablation of the atrioventricular node and permanent pacing do not negatively affect long-term survival in the absence of clinically significant heart disease.
During follow-up, 49 of the 78 patients who died (63 percent) died of cardiac causes. This high proportion is probably the result of the prevalence of cardiovascular diseases in our study population (Table 1). Five patients (1 percent of all the patients who underwent ablation) had sudden death from cardiac causes, and in four of them, underlying heart disease with left ventricular dysfunction had previously been documented. Earlier studies from a registry of patients who underwent direct-current ablation of the atrioventricular node estimated that the prevalence of sudden death from cardiac causes after ablation is between 2.04 percent and 3.70 percent.22,33 Most sudden deaths occurred in patients with preexisting heart disease.
Our observations and conclusions should be interpreted in the light of the limitations imposed by a retrospective study design. All the information was obtained from original hospital records of the Mayo Clinic. Although these records were interpreted and transferred into a standard data format, most of the information was qualitative. The multivariate model was used to minimize the effect of base-line differences. Selection of the study patients and the control population was not random, but the inclusion of consecutive patients minimized selection bias. Although the relative benefit of ablation of the atrioventricular node and permanent pacing, as compared with other methods of treatment, can be determined only by prospective, randomized trials, it is unlikely that such studies will be conducted, given the difficulties in maintaining sinus rhythm and controlling the ventricular rate by other medical and nonmedical methods, the diverse population of patients, and the high rate of crossover that would be expected.
Although the observed overall survival among the patients in our study who underwent ablation was significantly worse than the expected survival among matched controls from the Minnesota population, the observed survival among patients without overt heart disease was similar to that of the general-population controls, and no deaths occurred during follow-up among patients with lone atrial fibrillation. Survival rates were similar in the group receiving medical treatment for atrial fibrillation and the group that underwent ablation of the atrioventricular node. These observations suggest that permanent atrioventricular block and implantation of a pacemaker after ablation of the atrioventricular node do not have an important adverse effect on survival, thus reassuring patients and physicians that ablation of the atrioventricular node is an acceptable treatment option for symptomatic atrial fibrillation that is refractory to medical therapy.
Source Information
From the Division of Cardiovascular Diseases and Internal Medicine (C.O., A.J., P.A.F., P.J.P., T.M.M., R.F.R., M.A.L., D.L.P., B.J.G., S.C.H., W.-K.S.) and the Section of Biostatistics (D.O.H.), Mayo Clinic, Rochester, Minn.
Address reprint requests to Dr. Shen at the Mayo Clinic, 200 First St. SW, Rochester, MN 55905.
- References
References
1
Benjamin EJ ,Wolf PA ,D'Agostino RB ,Silbershatz H ,Kannel WB ,Levy D . Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 1998;98:946-952
Web of Science | Medline2
Lake FR ,Cullen KJ ,de Klerk NH ,McCall MG ,Rosman DL . Atrial fibrillation and mortality in an elderly population. Aust N Z J Med 1989;19:321-326
CrossRef | Medline3
Kannel WB ,Abbott RD ,Savage DD ,McNamara PM . Epidemiologic features of chronic atrial fibrillation: the Framingham Study. N Engl J Med 1982;306:1018-1022
Full Text | Web of Science | Medline4
Gajewski J ,Singer RB . Mortality in an insured population with atrial fibrillation. JAMA 1981;245:1540-1544
CrossRef | Web of Science | Medline5
Phillips SJ ,Whisnant JP ,O'Fallon WM ,Frye RL . Prevalence of cardiovascular disease and diabetes mellitus in residents of Rochester, Minnesota. Mayo Clin Proc 1990;65:344-359
Web of Science | Medline6
Wolf PA ,Abbott RD ,Kannel WB . Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991;22:983-988
CrossRef | Web of Science | Medline7
2000 Heart and stroke statistical update. Dallas: American Heart Association, 1999.
8
Nemec J ,Shen W-K . Pharmacotherapy of atrial fibrillation. Expert Opin Pharmacother 1999;1:81-96
CrossRef | Medline9
Antman EM ,Beamer AD ,Cantillon C ,McGowan N ,Friedman PL . Therapy of refractory symptomatic atrial fibrillation and atrial flutter: a staged care approach with new antiarrhythmic drugs. J Am Coll Cardiol 1990;15:698-707
CrossRef | Web of Science | Medline10
Pritchett ELC . Management of atrial fibrillation. N Engl J Med 1992;326:1264-1271
Full Text | Web of Science | Medline11
Zehender M ,Hohnloser S ,Muller B ,Meinertz T ,Just H . Effects of amiodarone versus quinidine and verapamil in patients with chronic atrial fibrillation: results of a comparative study and a 2-year follow-up. J Am Coll Cardiol 1992;19:1054-1059
CrossRef | Web of Science | Medline12
Crijns HJ ,Van Gelder IC ,Van Gilst WH ,Hillege H ,Gosselink AM ,Lie KI . Serial antiarrhythmic drug treatment to maintain sinus rhythm after electrical cardioversion for chronic atrial fibrillation or atrial flutter. Am J Cardiol 1991;68:335-341
CrossRef | Web of Science | Medline13
Prystowsky EN ,Benson DW Jr ,Fuster V , et al. Management of patients with atrial fibrillation: a statement for healthcare professionals: from the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association. Circulation 1996;93:1262-1277
Web of Science | Medline14
Touboul P . Atrioventricular nodal ablation and pacemaker implantation in patients with atrial fibrillation. Am J Cardiol 1999;83:241D-245D
CrossRef | Web of Science | Medline15
Brignole M ,Menozzi C . Control of rapid heart rate in patients with atrial fibrillation: drugs or ablation? Pacing Clin Electrophysiol 1996;19:348-356
CrossRef | Web of Science | Medline16
Brignole M . Ablate and pace: a pragmatic approach to paroxysmal atrial fibrillation not controlled by antiarrhythmic drugs. Heart 1998;79:531-533
Web of Science | Medline17
Twidale N ,Sutton K ,Bartlett L , et al. Effects on cardiac performance of atrioventricular node catheter ablation using radiofrequency current for drug-refractory atrial arrhythmias. Pacing Clin Electrophysiol 1993;16:1275-1284
CrossRef | Web of Science | Medline18
Marshall HJ ,Harris ZI ,Griffith MJ ,Gammage MD . Atrioventricular nodal ablation and implantation of mode switching dual chamber pacemakers: effective treatment for drug refractory paroxysmal atrial fibrillation. Heart 1998;79:543-547
Web of Science | Medline19
Kay GN ,Ellenbogen KA ,Giudici M , et al. The Ablate and Pace Trial: a prospective study of catheter ablation of the AV conduction system and permanent pacemaker implantation for treatment of atrial fibrillation. J Interv Card Electrophysiol 1998;2:121-135
CrossRef | Web of Science | Medline20
Fitzpatrick AP ,Kourouyan HD ,Siu A , et al. Quality of life and outcomes after radiofrequency His-bundle catheter ablation and permanent pacemaker implantation: impact of treatment in paroxysmal and established atrial fibrillation. Am Heart J 1996;131:499-507
CrossRef | Web of Science | Medline21
Therneau T, Sicks J, Bergstralh E, Offord J. Expected survival based on hazard rates. Technical report series. No. 52. Section of biostatistics. Rochester, Minn.: Mayo Clinic, March 1994.
22
Trohman RG ,Simmons TW ,Moore SL ,Firstenberg MS ,Williams D ,Maloney JD . Catheter ablation of the atrioventricular junction using radiofrequency energy and a bilateral cardiac approach. Am J Cardiol 1992;70:1438-1443
CrossRef | Web of Science | Medline23
Olgin JE ,Scheinman MM . Comparison of high energy direct current and radiofrequency catheter ablation of the atrioventricular junction. J Am Coll Cardiol 1993;21:557-564
CrossRef | Web of Science | Medline24
Peto R ,Peto J . Asymptotically efficient rank invariant test procedures. J R Stat Soc [A] 1972;135:185-206
CrossRef | Web of Science25
Cox DR . Regression models and life-tables. J R Stat Soc [B] 1972;34:187-22026
Krahn AD ,Manfreda J ,Tate RB ,Mathewson FA ,Cuddy TE . The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. Am J Med 1995;98:476-484
CrossRef | Web of Science | Medline27
Dries DL ,Exner DV ,Gersh BJ ,Domanski MJ ,Waclawiw MA ,Stevenson LW . Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials: Studies of Left Ventricular Dysfunction. J Am Coll Cardiol 1998;32:695-703
CrossRef | Web of Science | Medline28
Wolf PA ,Mitchell JB ,Baker CS ,Kannel WB ,D'Agostino RB . Impact of atrial fibrillation on mortality, stroke, and medical costs. Arch Intern Med 1998;158:229-234
CrossRef | Web of Science | Medline29
Brignole M ,Menozzi C ,Gianfranchi L , et al. Assessment of atrioventricular junction ablation and VVIR pacemaker versus pharmacological treatment in patients with heart failure and chronic atrial fibrillation: a randomized, controlled study. Circulation 1998;98:953-960
Web of Science | Medline30
Brignole M ,Gianfranchi L ,Menozzi C , et al. Assessment of atrioventricular junction ablation and DDDR mode-switching pacemaker versus pharmacological treatment in patients with severely symptomatic paroxysmal atrial fibrillation: a randomized controlled study. Circulation 1997;96:2617-2624
Web of Science | Medline31
Brand FN ,Abbott RD ,Kannel WB ,Wolf PA . Characteristics and prognosis of lone atrial fibrillation: 30-year follow-up in the Framingham Study. JAMA 1985;254:3449-3453
CrossRef | Web of Science | Medline32
Kopecky SL ,Gersh BJ ,McGoon MD , et al. The natural history of lone atrial fibrillation: a population-based study over three decades. N Engl J Med 1987;317:669-674
Full Text | Web of Science | Medline33
Scheinman MM ,Morady F ,Hess DS ,Gonzalez R . Catheter-induced ablation of the atrioventricular junction to control refractory supraventricular arrhythmias. JAMA 1982;248:851-855
CrossRef | Web of Science | Medline
- Citing Articles (89)
Citing Articles
1
Mackram F Eleid, Win-Kuang Shen. (2011) Role of atrioventricular nodal ablation and pacemaker therapy in elderly patients with recurrent atrial fibrillation. Interventional Cardiology 3:6, 713-720
CrossRef2
Gregory YH Lip, Hung Fat Tse, Deirdre A Lane. (2011) Atrial fibrillation. The Lancet
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Attila Mihálcz, Pál Ábrahám, Attila Kardos, Csaba Földesi, Tamás Szili-Török. (2011) Kardiális reszinkronizációs terápia pitvarfibrilláló betegekben. Orvosi Hetilap 152:44, 1757-1763
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Jason C. Rubenstein, James A. Roth. (2011) Atrioventricular junction ablation and pacemaker implantation for heart failure associated with atrial fibrillation: potential issues and therapies in the setting of acute heart failure syndrome. Heart Failure Reviews 16:5, 457-465
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Andrew J. Brenyo, Mehmet K. Aktas. (2011) Non-Pharmacologic Management of Atrial Fibrillation. The American Journal of Cardiology 108:2, 317-325
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Yasutsugu Nagamoto, Tomohito Inage, Teruhisa Yoshida, Tomohiro Takeuchi, Takeki Gondo, Yujiro Fukuda, Eiichi Takii, Kenta Murotani, Tsutomu Imaizumi. (2011) Atrioventricular nodal ablation versus antiarrhythmic drugs after permanent pacemaker implantation for bradycardia-tachycardia syndrome. Heart and Vessels
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SYED S. RAZA, JIAN-MING LI, RANJIT JOHN, LIN Y. CHEN, VENKATAKRISHNA N. THOLAKANAHALLI, MACKENZIE MBAI, A. SELCUK ADABAG. (2011) Long-Term Mortality and Pacing Outcomes of Patients with Permanent Pacemaker Implantation after Cardiac Surgery. Pacing and Clinical Electrophysiology 34:3, 331-338
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Laurent M. Haegeli, Firat Duru. (2011) Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age. Cardiology Research and Practice 2011, 1-8
CrossRef9
, , , A. J. Camm, P. Kirchhof, G. Y. H. Lip, U. Schotten, I. Savelieva, S. Ernst, I. C. Van Gelder, N. Al-Attar, G. Hindricks, B. Prendergast, H. Heidbuchel, O. Alfieri, A. Angelini, D. Atar, P. Colonna, R. De Caterina, J. De Sutter, A. Goette, B. Gorenek, M. Heldal, S. H. Hohloser, P. Kolh, J.-Y. Le Heuzey, P. Ponikowski, F. H. Rutten, , A. Vahanian, A. Auricchio, J. Bax, C. Ceconi, V. Dean, G. Filippatos, C. Funck-Brentano, R. Hobbs, P. Kearney, T. McDonagh, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirnes, M. Tendera, P. E. Vardas, P. Widimsky, , P. E. Vardas, V. Agladze, E. Aliot, T. Balabanski, C. Blomstrom-Lundqvist, A. Capucci, H. Crijns, B. Dahlof, T. Folliguet, M. Glikson, M. Goethals, D. C. Gulba, S. Y. Ho, R. J. M. Klautz, S. Kose, J. McMurray, P. Perrone Filardi, P. Raatikainen, M. J. Salvador, M. J. Schalij, A. Shpektor, J. Sousa, J. Stepinska, H. Uuetoa, J. L. Zamorano, I. Zupan. (2010) Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace 12:10, 1360-1420
CrossRef10
, , , A. J. Camm, P. Kirchhof, G. Y. H. Lip, U. Schotten, I. Savelieva, S. Ernst, I. C. Van Gelder, N. Al-Attar, G. Hindricks, B. Prendergast, H. Heidbuchel, O. Alfieri, A. Angelini, D. Atar, P. Colonna, R. De Caterina, J. De Sutter, A. Goette, B. Gorenek, M. Heldal, S. H. Hohloser, P. Kolh, J.-Y. Le Heuzey, P. Ponikowski, F. H. Rutten, , A. Vahanian, A. Auricchio, J. Bax, C. Ceconi, V. Dean, G. Filippatos, C. Funck-Brentano, R. Hobbs, P. Kearney, T. McDonagh, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirnes, M. Tendera, P. E. Vardas, P. Widimsky, , P. E. Vardas, V. Agladze, E. Aliot, T. Balabanski, C. Blomstrom-Lundqvist, A. Capucci, H. Crijns, B. Dahlof, T. Folliguet, M. Glikson, M. Goethals, D. C. Gulba, S. Y. Ho, R. J. M. Klautz, S. Kose, J. McMurray, P. Perrone Filardi, P. Raatikainen, M. J. Salvador, M. J. Schalij, A. Shpektor, J. Sousa, J. Stepinska, H. Uuetoa, J. L. Zamorano, I. Zupan. (2010) Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). European Heart Journal 31:19, 2369-2429
CrossRef11
Mark Alber Meshil, Deepak Bhakta. (2010) REVIEW: Nonpharmacological Therapies for Atrial Fibrillation. Cardiovascular Therapeutics 28:5, 264-277
CrossRef12
Kan Dong, Win-Kuang Shen, Brian D. Powell, Ying-Xu Dong, Robert F. Rea, Paul A. Friedman, David O. Hodge, Heather J. Wiste, Tracy Webster, David L. Hayes, Yong-Mei Cha. (2010) Atrioventricular nodal ablation predicts survival benefit in patients with atrial fibrillation receiving cardiac resynchronization therapy. Heart Rhythm 7:9, 1240-1245
CrossRef13
Andrew J. Krainik, Jane Chen. (2010) Atrial Fibrillation in the Elderly. Current Cardiovascular Risk Reports 4:5, 354-360
CrossRef14
N. Bottoni, M. Tritto, R. Ricci, M. Accogli, M. Di Biase, S. Iacopino, M. Iori, S. Themistoclakis, N. Sitta, G. Spadacini, R. De Ponti, M. Brignole, . (2010) Adherence to guidelines for atrial fibrillation management of patients referred to cardiology departments: Studio Italiano multicentrico sul Trattamento della Fibrillazione Atriale (SITAF). Europace 12:8, 1070-1077
CrossRef15
RISHI ARORA, ERICA SPATZ, PUGAZHENDHI VIJAYARAMAN, MICHAEL ROSENGARTEN, JAY GROSS, SOO KIM, JOHN FISHER, KEVIN J. FERRICK. (2010) Just How Stable Are Escape Rhythms after Atrioventricular Junction Ablation?. Pacing and Clinical Electrophysiologyno-no
CrossRef16
Jens Seiler, William G. Stevenson. (2010) Atrial Fibrillation in Congestive Heart Failure. Cardiology in Review 18:1, 38-50
CrossRef17
Brent C. Lampert, Hans J. Moore, Richard L. Amdur, Pamela E. Karasik, Brian M. Lewis, Steven N. Singh, Ross D. Fletcher. (2010) Long-Term Mortality Outcomes According to the Frequency of Right Ventricular Pacing in Veterans. Cardiology Research and Practice 2010, 1-8
CrossRef18
Kai Sonne, Dimpi Patel, Prasant Mohanty, Luciana Armaganijan, Lucie Riedlbauchova, Moataz El-Ali, Luigi Biase, Preeti Venkatraman, Mazen Shaheen, Marketa Kozeluhova, Robert Schweikert, J. David Burkhardt, Robert Canby, Oussama Wazni, Walid Saliba, Andrea Natale. (2009) Pulmonary vein antrum isolation, atrioventricular junction ablation, and antiarrhythmic drugs combined with direct current cardioversion: survival rates at 7 years follow-up. Journal of Interventional Cardiac Electrophysiology 26:2, 121-126
CrossRef19
M. Gasparini, F. Regoli, P. Galimberti, C. Ceriotti, A. Cappelleri. (2009) Cardiac resynchronization therapy in heart failure patients with atrial fibrillation. Europace 11:Supplement 5, v82-v86
CrossRef20
Rajat Jhanjee, Ilknur Can, David G. Benditt. (2009) Syncope. Disease-a-Month 55:9, 532-585
CrossRef21
TAKUMI YAMADA, G. NEAL KAY. (2009) Catheter Ablation of Atrial Fibrillation in the Elderly. Pacing and Clinical Electrophysiology 32:8, 1085-1091
CrossRef22
T. Weimar, N. Doll. (2009) Kleine Schnitte – große Wirkung. Zeitschrift für Herz-,Thorax- und Gefäßchirurgie 23:3, 145-154
CrossRef23
Sharon Ann Hunt, William T. Abraham, Marshall H. Chin, Arthur M. Feldman, Gary S. Francis, Theodore G. Ganiats, Mariell Jessup, Marvin A. Konstam, Donna M. Mancini, Keith Michl, John A. Oates, Peter S. Rahko, Marc A. Silver, Lynne Warner Stevenson, Clyde W. Yancy. (2009) 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults. Journal of the American College of Cardiology 53:15, e1-e90
CrossRef24
Mariell Jessup, William T. Abraham, Donald E. Casey, Arthur M. Feldman, Gary S. Francis, Theodore G. Ganiats, Marvin A. Konstam, Donna M. Mancini, Peter S. Rahko, Marc A. Silver, Lynne Warner Stevenson, Clyde W. Yancy. (2009) 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. Journal of the American College of Cardiology 53:15, 1343-1382
CrossRef25
Wilbert S. Aronow. (2009) Acute and Chronic Management of Atrial Fibrillation in Patients With Late-Stage CKD. American Journal of Kidney Diseases 53:4, 701-710
CrossRef26
DRITAN POÇI, LOTTA BACKMAN, THOMAS KARLSSON, NILS EDVARDSSON. (2009) New or Aggravated Heart Failure during Long-Term Right Ventricular Pacing after AV Junctional Catheter Ablation. Pacing and Clinical Electrophysiology 32:2, 209-216
CrossRef27
Ziad F. Issa, John M. Miller, Douglas P. Zipes. 2009. Atrial Fibrillation. , 208-286.
CrossRef28
Hans-Ruprecht Neuberger, Jan-Christian Reil, Oliver Adam, Ulrich Laufs, Christian Mewis, Michael Böhm. (2008) Atrial fibrillation in heart failure: Current treatment of patients with remodeled atria. Current Heart Failure Reports 5:4, 219-225
CrossRef29
Wangden Carson, Yung-Zu Tseng. (2008) Negative sequence voltages in spontaneous atrial fibrillation or flutter. International Journal of Cardiology 130:3, 357-366
CrossRef30
DAVID M. LURIA, DAVID O. HODGE, KRISTI H. MONAHAN, JANIS M. HAROLDSON, WIN-KUANG SHEN, SAMUEL J. ASIRVATHAM, STEPHEN C. HAMMILL, THOMAS M. MUNGER, MICHAEL GLIKSON, BERNARD J. GERSH, DOUGLAS L. PACKER, PAUL A. FRIEDMAN. (2008) Effect of Radiofrequency Ablation of Atrial Flutter on the Natural History of Subsequent Atrial Arrhythmias. Journal of Cardiovascular Electrophysiology 19:11, 1145-1150
CrossRef31
Gaurav A. Upadhyay, Niteesh K. Choudhry, Angelo Auricchio, Jeremy Ruskin, Jagmeet P. Singh. (2008) Cardiac Resynchronization in Patients With Atrial Fibrillation. Journal of the American College of Cardiology 52:15, 1239-1246
CrossRef32
A. Proclemer, G. Allocca, D. Gregori, C. Bonanno, R. Ometto, A. Fontanelli, R. Mantovan, M. Crosato, V. Calzolari, D. Pavoni, D. Facchin, L. Rebellato, P. M. Fioretti. (2008) Radiofrequency ablation of drug-refractory atrial fibrillation: an observational study comparing 'ablate and pace' with pulmonary vein isolation. Europace 10:9, 1085-1090
CrossRef33
Wilbert S. Aronow. (2008) Etiology, Pathophysiology, and Treatment of Atrial Fibrillation. Cardiology in Review 16:4, 181-188
CrossRef34
M. Gasparini, A. Auricchio, M. Metra, F. Regoli, C. Fantoni, B. Lamp, A. Curnis, J. Vogt, C. Klersy, . (2008) Long-term survival in patients undergoing cardiac resynchronization therapy: the importance of performing atrio-ventricular junction ablation in patients with permanent atrial fibrillation. European Heart Journal 29:13, 1644-1652
CrossRef35
Gabriel Vanerio, Juan L. Vidal, Pablo Fernández Banizi, Daniel Banina Aguerre, Pablo Viana, Jorge Tejada. (2008) Medium- and long-term survival after pacemaker implant: Improved survival with right ventricular outflow tract pacing. Journal of Interventional Cardiac Electrophysiology 21:3, 195-201
CrossRef36
John A. Chiladakis, Nikolaos Koutsogiannis, Andreas Kalogeropoulos, Panagiotis Arvanitis, Dimitrios Alexopoulos. (2008) Adverse Effects of Continuous Ventricular Pacing in Patients with Slower Atrial Fibrillation and Normal Left Ventricular Systolic Function. Annals of Noninvasive Electrocardiology 13:2, 130-136
CrossRef37
Young-Hoon Jeong, Kee-Joon Choi, Jong-Min Song, Eui-Seock Hwang, Kyoung-Min Park, Gi-Byoung Nam, Jae-Joong Kim, You-Ho Kim. (2008) Diagnostic Approach and Treatment Strategy in Tachycardia-induced Cardiomyopathy. Clinical Cardiology 31:4, 172-178
CrossRef38
Michiel Rienstra, Isabelle C Van Gelder. (2008) Who, when and how to rate control for atrial fibrillation. Current Opinion in Internal Medicine 7:2, 113-117
CrossRef39
Jeffrey J. Goldberger, Robert O. Bonow, Michael Cuffe, Alan Dyer, Philip Greenland, Yves Rosenberg, Robert O'Rourke, Prediman K. Shah, Sidney Smith. (2008) Post–myocardial infarction β-blocker therapy: The bradycardia conundrum. Rationale and design for the Pacemaker & β-blocker therapy post-MI (PACE-MI) trial. American Heart Journal 155:3, 455-464
CrossRef40
Jane Chen, Margaret C. Fang, Michael W. Rich. (2008) The Reply:. The American Journal of Medicine 121:3, e11
CrossRef41
N. Doll, M. Czesla, S. Jacobs, M. Borger, F. W. Mohr. (2008) Update Vorhofflimmer-Chirurgie 2008. Zeitschrift für Herz-,Thorax- und Gefäßchirurgie 22:1, 23-31
CrossRef42
Wilbert S Aronow, Carmine Sorbera. 2008. Supraventricular Tachyarrhythmias in the Elderly. , 577-604.
CrossRef43
Ahmad Zankar, Jose A. Joglar, R Haris Naseem. (2007) Cardiac Resynchronization Therapy in Patients With Chronic Atrial Fibrillation. Cardiology in Review 15:6, 310-315
CrossRef44
ZIAD F. ISSA. (2007) An Approach to Ablate and Pace:AV Junction Ablation and Pacemaker Implantation Performed Concurrently from the Same Venous Access Site. Pacing and Clinical Electrophysiology 30:9, 1116-1120
CrossRef45
Giuseppe Boriani, Luigi Padeletti, Massimo Santini, Michele Gulizia, Serafino Orazi, GianLuca Botto, Alessandro Capucci, Mauro Biffi, Cristian Martignani, Renato Ricci, Marco Vimercati, Paola DiStefano, Andrea Grammatico. (2007) Rate control in patients with pacemaker affected by brady-tachy form of sick sinus syndrome. American Heart Journal 154:1, 193-200
CrossRef46
B.-D. Gonska. (2007) Stellenwert der Katheterablation bei paroxysmalem und persistierendem/permanentem Vorhofflimmern. Clinical Research in Cardiology Supplements 2:4, IV64-IV70
CrossRef47
M. Knaut. (2007) Geschichte der Rhythmuschirurgie mit Fokus auf die chirurgischen Ablationsverfahren zur Behandlung des Vorhofflimmerns. Herzschrittmachertherapie & Elektrophysiologie 18:2, 54-61
CrossRef48
Margaret C. Fang, Jane Chen, Michael W. Rich. (2007) Atrial Fibrillation in the Elderly. The American Journal of Medicine 120:6, 481-487
CrossRef49
Gregory K. Feld. (2007) Atrioventricular node modification and ablation for ventricular rate control in atrial fibrillation. Heart Rhythm 4:3, S80-S83
CrossRef50
D J Bradley, W-K Shen. (2007) Overview of Management of Atrial Fibrillation in Symptomatic Elderly Patients: Pharmacologic Therapy Versus AV Node Ablation. Clinical Pharmacology & Therapeutics 81:2, 284-287
CrossRef51
David J. Bradley, Win-Kuang Shen. (2007) Atrioventricular junction ablation combined with either right ventricular pacing or cardiac resynchronization therapy for atrial fibrillation: The need for large-scale randomized trials. Heart Rhythm 4:2, 224-232
CrossRef52
Hirofumi Tasaki, Kiyotaka Matsuo, Norihiro Komiya, Shinji Seto, Katsusuke Yano. (2007) Transient T wave Changes Concerning Arrhythmia. Journal of Arrhythmia 23:2, 115-123
CrossRef53
MOHAMED H. HAMDAN, ROGER A. FREEDMAN, EDWARD M. GILBERT, JOHN P. DIMARCO, KENNETH A. ELLENBOGEN, RICHARD L. PAGE. (2006) Atrioventricular Junction Ablation Followed by Resynchronization Therapy in Patients with Congestive Heart Failure and Atrial Fibrillation (AVERT-AF) Study Design. Pacing and Clinical Electrophysiology 29:10, 1081-1088
CrossRef54
Jonathan S. Steinberg. (2006) Desperately Seeking a Randomized Clinical Trial of Resynchronization Therapy for Patients With Heart Failure and Atrial Fibrillation
Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.. Journal of the American College of Cardiology 48:4, 744-746
CrossRef55
Aamir Cheema, Hugh Calkins. 2006. Atrial Arrhythmia. , 167-182.
CrossRef56
T. Lewalter, G. Nickenig. (2006) Pharmakotherapie der supraventrikulären Rhythmusstörungen. Der Internist 47:1, 80-88
CrossRef57
RAHUL N. DOSHI, EMILE G. DAOUD, CHRISTOPHER FELLOWS, KYONG TURK, AURELIO DURAN, MOHAMED H. HAMDAN, LUIS A. PIRES, . (2005) Left Ventricular-Based Cardiac Stimulation Post AV Nodal Ablation Evaluation (The PAVE Study). Journal of Cardiovascular Electrophysiology 16:11, 1160-1165
CrossRef58
D. George Wyse. (2005) Rate Control vs Rhythm Control Strategies in Atrial Fibrillation. Progress in Cardiovascular Diseases 48:2, 125-138
CrossRef59
Gregory K. Bruce, Paul A. Friedman. (2005) Device-based therapies for atrial fibrillation. Current Treatment Options in Cardiovascular Medicine 7:5, 359-370
CrossRef60
Soraya M. Samii, B. John Hynes, Mazhar Khan, Deborah L. Wolbrette, Jerry C. Luck, Gerald V. Naccarelli. (2005) Selection of Drugs in Pursuit of Rate Control Strategy. Progress in Cardiovascular Diseases 48:2, 146-152
CrossRef61
Jeffrey J. Goldberger. (2005) Right ventricular pacing: Has DAVID slain this Goliath?. Heart Rhythm 2:8, 835-836
CrossRef62
J. David Burkhardt, Bruce L. Wilkoff. 2005. Atrioventricular Node Ablation. , 87-92.
CrossRef63
Angelo Auricchio. (2005) Cardiac resynchronization therapy: does varying the pacing site or combination of sites improve cardiac function?. Nature Clinical Practice Cardiovascular Medicine 2:6, 288-289
CrossRef64
MING-HSIUNG HSIEH, CHING-TAI TAI, SHIH-HUANG LEE, HUAN-MING TSAO, YUNG-KUO LIN, JIN-LONG HUANG, PAUL CHAN, YI-JEN CHEN, JEN-YUAN KUO, TA-CHUAN TUAN, TSUI-LIEH HSU, CHI-WOON KONG, SHIH-LIN CHANG, SHIH-ANN CHEN. (2005) Catheter Ablation of Atrial Fibrillation Versus Atrioventricular Junction Ablation Plus Pacing Therapy for Elderly Patients with Medically Refractory Paroxysmal Atrial Fibrillation. Journal of Cardiovascular Electrophysiology 16:5, 457-461
CrossRef65
CARINA M. BLOMSTROM-LUNDQVIST. (2005) Non-Pharmacological Rate or Rhythm Control-It Is Time for Randomized Studies. Journal of Cardiovascular Electrophysiology 16:5, 462-464
CrossRef66
Dawood Darbar, Dan M. Roden. (2005) Symptomatic burden as an endpoint to evaluate interventions in patients with atrial fibrillation. Heart Rhythm 2:5, 544-549
CrossRef67
Heather M. Ross, Dusan Z. Kocovic, Peter R. Kowey. (2005) Pharmacologic Therapies for Atrial Fibrillation. The American Journal of Geriatric Cardiology 14:2, 62-67
CrossRef68
Rik Willems, Hein Heidbüchel. (2005) Nonpharmacologic Treatment of Atrial Fibrillation in Elderly Persons. The American Journal of Geriatric Cardiology 14:2, 68-72
CrossRef69
Ashish Agarwal, Meghan York, Bharat K. Kantharia, Michael Ezekowitz. (2005) Atrial Fibrillation: Modern Concepts and Management. Annual Review of Medicine 56:1, 475-494
CrossRef70
Ronald E. Vlietstra, Arshad Jahangir, Win K. Shen. (2005) Choice of Pacemakers in Patients Aged 75 Years and Older: Ventricular Pacing Mode vs. Dual-Chamber Pacing Mode. The American Journal of Geriatric Cardiology 14:1, 35-38
CrossRef71
Mario D. Gonzalez. (2005) Rate Control vs. Pulmonary Vein Isolation. The American Journal of Geriatric Cardiology 14:1, 26-30
CrossRef72
Hsu, Li-Fern, Jaïs, Pierre, Sanders, Prashanthan, Garrigue, Stéphane, Hocini, Mélèze, Sacher, Fréderic, Takahashi, Yoshihide, Rotter, Martin, Pasquié, Jean-Luc, Scavée, Christophe, Bordachar, Pierre, Clémenty, Jacques, Haïssaguerre, Michel, . (2004) Catheter Ablation for Atrial Fibrillation in Congestive Heart Failure. New England Journal of Medicine 351:23, 2373-2383
Full Text73
Nicholas Z Kerin, Randy A Lieberman. (2004) Atrial Fibrillation: Focus on New Therapeutic Strategies. American Journal of Therapeutics 11:6, 489-493
CrossRef74
YOUHUA ZHANG, TODOR N. MAZGALEV. (2004) Ventricular Rate Control During Atrial Fibrillation and AV Node Modifications:. Pacing and Clinical Electrophysiology 27:3, 382-393
CrossRef75
Angelo Auricchio. (2004) Pacing the left ventricle: does underlying rhythm matter?. Journal of the American College of Cardiology 43:2, 239-240
CrossRef76
DOUGLAS L. PACKER, SAM ASIRVATHAM, THOMAS M. MUNGER. (2003) Progress in Nonpharmacologic Therapy of Atrial Fibrillation. Journal of Cardiovascular Electrophysiology 14:s12, S296-S309
CrossRef77
HENRY J. DUFF, SATISH R. RAJ, DEREK V. EXNER, ROBERT S. SHELDON, DAN ROACH, L. BRENT MITCHELL, D. GEORGE WYSE, MARGARET MORCK, ANNE M. GILLIS. (2003) Randomized Controlled Trial of Fixed Rate Versus Rate Responsive Pacing After Radiofrequency Atrioventricular Junction Ablation:. Journal of Cardiovascular Electrophysiology 14:11, 1163-1170
CrossRef78
Jane Chen, Michael W. Rich. (2003) Atrial fibrillation in the elderly. Current Treatment Options in Cardiovascular Medicine 5:5, 355-367
CrossRef79
Rukshen Weerasooriya, Michael Davis, Anne Powell, Tamas Szili-Torok, Chetan Shah, David Whalley, Logan Kanagaratnam, William Heddle, James Leitch, Ann Perks, Louise Ferguson, Max Bulsara. (2003) The Australian intervention randomized control of rate in atrial fibrillation trial (AIRCRAFT). Journal of the American College of Cardiology 41:10, 1697-1702
CrossRef80
YOSHIHIDE TAKAHASHI, IESAKA YOSHITO, ATSUSHI TAKAHASHI, TOMOO HARADA, TAKESHI MITSUHASHI, KINYA SHIROTA, KOICHIRO KUMAGAI, NORIHITO NURUKI, TAKAYOSHI SHIRAISHI, JUNICHI NITTA, HIROSHI ITO, . (2003) AV Nodal Ablation and Pacemaker Implantation Improves Hemodynamic Function in Atrial Fibrillation. Pacing and Clinical Electrophysiology 26:5, 1212-1217
CrossRef81
SATISH R. RAJ, ANNE M. GILLIS, L. BRENT MITCHELL, D. GEORGE WYSE, ROBERT S. SHELDON, DEREK V. EXNER, MARGARET MORCK, HENRY J. DUFF. (2003) Paced QT Dispersion and QT Morphology After Radiofrequency Atrioventricular Junction Ablation:.. Pacing and Clinical Electrophysiology 26:3, 662-668
CrossRef82
MELVIN SCHEINMAN, HUGH CALKINS, PAUL GILLETTE, RICHARD KLEIN, BRUCE B. LERMAN, FRED MORADY, SANJEEV SAKSENA, ALBERT WALDO. (2003) NASPE Policy Statement on Catheter Ablation:.. Pacing and Clinical Electrophysiology 26:3, 789-799
CrossRef83
Ronald E. Vlietstra. (2002) Optimal Investigation of the Elderly and Very Elderly Patient With Atrial Fibrillation?What Must Be Done?. The American Journal of Geriatric Cardiology 11:6, 376-379
CrossRef84
Cevher Ozcan, Arshad Jahangir, Paul A Friedman, David L Hayes, Thomas M Munger, Robert F Rea, Margaret A Lloyd, Douglas L Packer, David O Hodge, Bernard J Gersh, Stephen C Hammill, Win-Kuang Shen. (2002) Sudden death after radiofrequency ablation of the atrioventricular node in patients with atrial fibrillation. Journal of the American College of Cardiology 40:1, 105-110
CrossRef85
W. S. Aronow. (2002) Management of the Older Person With Atrial Fibrillation. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:6, M352-M363
CrossRef86
Wilbert S. Aronow. (2002) Atrial Fibrillation. Heart Disease91-101
CrossRef87
Nicholas S Peters, Richard J Schilling, Prapa Kanagaratnam, Vias Markides. (2002) Atrial fibrillation: strategies to control, combat, and cure. The Lancet 359:9306, 593-603
CrossRef88
G. Muqtada Chaudhry, Charles I. Haffajee. (2002) Algorithms useful in the treatment of atrial fibrillation. Current Opinion in Cardiology 17:1, 52-57
CrossRef89
Stanley Nattel, Paul Khairy, Denis Roy, Bernard Thibault, Peter Guerra, Mario Talajic, Marc Dubuc. (2002) New Approaches to Atrial Fibrillation Management. Drugs 62:16, 2377-2397
CrossRef
