Atrioventricular junction ablation with permanent pacemaker implantation is a highly effective treatment approach in patients with atrial fibrillation and high ventricular rates resistant to other treatment modalities...Atrioventricular junction ablation with permanent pacemaker implantation is a highly effective treatment approach in patients with atrial fibrillation and high ventricular rates resistant to other treatment modalities, especially in the elderly or those with severe comorbidities. Compared with pharmacological therapy alone, the so-called ＂ablate and pace＂ approach offers the potential for more robust control ofven- tricular rate. Atrioventricular junction ablation and pacing strategy is associated with improvement in symptoms, quality of life, and exercise capacity. Given the close relationship between atrial fibrillation and heart failure, there is a particular benefit of such a rate control in patients with atrial fibrillation and reduced systolic fimction. There is increasing evidence that cardiac resynchronization therapy devices may be beneficial in selected populations after atrioventricular junction ablation. The present review article focuses on the current recommendations for atrioventricular junction ablation and pacing for heart rate control in patients with atrial fibrillation. The technique, the optimal implanta- tion time, and the proper device selection after atrioventricular junction ablation are also discussed.展开更多
The atrial pacing lead is believed having higher stimulation thresholds and long-term complication rates than ventricular lead, this being one of the factors limiting the use of dual chamber pacing. A prospective stud...The atrial pacing lead is believed having higher stimulation thresholds and long-term complication rates than ventricular lead, this being one of the factors limiting the use of dual chamber pacing. A prospective study was undertaken to evaluate both atrial and ventricular bipolar lined steroid-eluting leads in long-term dual chamber pacing. There are 81 pairs of leads (Medtronic Capsure SP) used in 81 patients. Bipolar atrial and ventricular stimulation thresholds were measured immediately post implantation and 1,3, 6,12,18 and 24 months. All leads demonstrated low mean stimulation thresholds during the follow-up and more than 94 % of leads could be paced chronically in the atrium and ventricle at 2.5 volts. In conclusion, atrial and ventricular steroid-eluting leads gave excellent stimulation thresholds allowing low energy long-term dual chamber pacing.展开更多
文摘Atrioventricular junction ablation with permanent pacemaker implantation is a highly effective treatment approach in patients with atrial fibrillation and high ventricular rates resistant to other treatment modalities, especially in the elderly or those with severe comorbidities. Compared with pharmacological therapy alone, the so-called ＂ablate and pace＂ approach offers the potential for more robust control ofven- tricular rate. Atrioventricular junction ablation and pacing strategy is associated with improvement in symptoms, quality of life, and exercise capacity. Given the close relationship between atrial fibrillation and heart failure, there is a particular benefit of such a rate control in patients with atrial fibrillation and reduced systolic fimction. There is increasing evidence that cardiac resynchronization therapy devices may be beneficial in selected populations after atrioventricular junction ablation. The present review article focuses on the current recommendations for atrioventricular junction ablation and pacing for heart rate control in patients with atrial fibrillation. The technique, the optimal implanta- tion time, and the proper device selection after atrioventricular junction ablation are also discussed.
文摘The atrial pacing lead is believed having higher stimulation thresholds and long-term complication rates than ventricular lead, this being one of the factors limiting the use of dual chamber pacing. A prospective study was undertaken to evaluate both atrial and ventricular bipolar lined steroid-eluting leads in long-term dual chamber pacing. There are 81 pairs of leads (Medtronic Capsure SP) used in 81 patients. Bipolar atrial and ventricular stimulation thresholds were measured immediately post implantation and 1,3, 6,12,18 and 24 months. All leads demonstrated low mean stimulation thresholds during the follow-up and more than 94 % of leads could be paced chronically in the atrium and ventricle at 2.5 volts. In conclusion, atrial and ventricular steroid-eluting leads gave excellent stimulation thresholds allowing low energy long-term dual chamber pacing.
