RT-238
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Heart failure patients with
atrial fibrillation: how important is it to regularise ventricular rhythm?
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Panos E. Vardas, Emmanuel N.
Simantirakis, Emmanuel G. Manios.
Cardiology Department, University Hospital of Heraklion, Crete, Greece
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Introduction
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Atrial fibrillation continues to be a focus of
scientific interest, because of its high incidence and also because of the increased
mortality and morbidity which it entails. Although the arrhythmia is usually paroxysmal in
nature in its early stages, in a large number of patients it becomes progressively more
frequent and eventually evolves into established atrial fibrillation. In the latter case
treatment has traditionally focused on the prevention of thromboembolic episodes and on
the control of the ventricular rate at rest and during exercise. It seems, however, that
the continuous changes in heart rate can play a significant role in the appearance of
symptoms and disturbances of left ventricular function1-3.
Thus, the last few years have seen a systematic examination of the possible benefit from
the regularisation of the ventricular rhythm by means of ablation of the atrio-ventricular
(AV) junction and the implantation of a rate responsive pacemaker4-6.
Furthermore, this approach has been used in recent years as an alternative therapy with
very good results in patients whose ventricular rate could not be controlled with drugs7-11.
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Key Words
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Pacing - congestive heart failure
atrial fibrillation, cardiac output, catheter ablation of AV junction, right ventricular
pacing, exercise performance, quality of life, OA
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