ATRIOVENTRICULAR NODAL ABLATION AND IMPLANTATION OF MODE SWITCHING DUAL-CHAMBER PACEMAKERS - EFFECTIVE TREATMENT FOR DRUG-REFRACTORY PAROXYSMAL ATRIAL-FIBRILLATION

Objective-To assess the effect of atrioventricular node ablation and i mplantation of a dual chamber, mode switching pacemaker on quality of life, exercise capacity, and left ventricular systolic function in pat ients with drug refractory paroxysmal atrial fibrillation. Patients-18 consecutive patients with drug refractory paroxysmal atrial fibrillat ion. Methods-Quality of life was assessed before and after the procedu re using the psychological general wellbeing index (PGWB), the McMaste r health index (MHI), and a visual analogue scale for cardiac symptoms . Nine of the patients also underwent symptom limited exercise tests a nd echocardiography to assess left ventricular systolic function. Resu lts-The procedure allowed a reduction in antiarrhythmic drug treatment (p < 0.01). PGWB and symptom scores improved (p < 0.01) but the MHI s core did not change. Left ventricular systolic function and exercise c apacity were unchanged. Conclusions-Atrioventricular node ablation and implantation of a DDDR/MS pacemaker is effective treatment for refrac tory paroxysmal atrial fibrillation, producing improved quality of Lif e while allowing a reduction in drug burden. The popularity of the tre atment is justified, but further studies are needed to determine optim um timing of intervention.