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.