Prospective, randomized study of atrioventricular ablation and mode-switching, dual chamber pacemaker implantation versus medical therapy in drug-resistant paroxysmal atrial fibrillation - The PAF study

We performed a prospective randomized 6-month evaluation of the clinical ef fects of atrioventricular junctional ablation together with placement of a DDDR mode-switching pacemaker vs pharmacological treatment in 43 patients w ith intolerable paroxysmal atrial fibrillation not controlled with antiarrh ythmic drugs. Ablation and pacemaker treatment were highly effective and su perior to drug therapy in controlling symptoms and improving quality of lif e. However, discontinuation of drug therapy exposed patients to further rec urrences of paroxysmal atrial fibrillation and the risk of developing perma nent atrial fibrillation.