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CRT and AVJ Ablation Superior for Heart Failure Patients

Sustained improvement with cardiac resynchronization therapy, atrioventricular junction ablation

TUESDAY, Aug. 29 (HealthDay News) -- Heart failure patients who exhibited ventricular conduction and atrial fibrillation showed sustained improvement if treated with cardiac resynchronization therapy (CRT) and atrioventricular junction (AVJ) ablation, according to a report in the Aug. 15 issue of the Journal of the American College of Cardiology.

Maurizio Gasparini, M.D., of the Istituto Clinico Humanitas Rozzano-Milano in Milan, Italy, and colleagues compared the effect of CRT on ventricular function in 48 patients with permanent atrial fibrillation in whom ventricular rate was treated with drugs and in 114 patients with permanent atrial fibrillation who had undergone AVJ ablation. The patients' clinical and long-term echocardiographic outcomes were then compared with 511 heart failure patients with sinus rhythm who were treated with CRT.

The researchers found that the patients with sinus rhythm and permanent atrial fibrillation experienced similar benefits from CRT. However, among permanent atrial fibrillation patients, only those who underwent AVJ ablation displayed improved left ventricular function and a symptomatic benefit that was sustained for up to four years.

"The combination of CRT and AVJ ablation is a superior treatment strategy in heart failure patients with atrial fibrillation," the authors write. "Large randomized studies would be useful to further confirm these results."

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