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Long-Term Survival after Ablation of the Atrioventricular Node and Implantation of a Permanent Pacemaker in Patients with Atrial Fibrillation

Open access
Ozcan, Cevher, Jahangir, Arshad, Friedman, Paul A., Patel, Philip J., Munger, Thomas M., Rea, Robert F., Lloyd, Margaret A., Packer, Douglas L., Hodge, David O., Hayes, David L., Gersh, Bernard J., Hammill, Stephen C., Shen, Win-Kuang·2001·New England Journal of Medicine

Abstract

BACKGROUND: In patients with atrial fibrillation that is refractory to drug therapy, radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker are an alternative therapeutic approach. The effect of this procedure on long-term survival is unknown. METHOD: We studied all patients who underwent ablation of the atrioventricular node and implantation of a permanent pacemaker at the Mayo Clinic between 1990 and 1998. Observed survival was compared with the survival rates in two control populations: age- and sex-matched members of the Minnesota population between 1970 and 1990 and consecutive patients with atrial fibrillation who received drug therapy in 1993. RESULTS: A total of 350 patients (mean [+/-SD] age, 68+/-11 years) were studied. During a mean of 36+/-26 months of follow-up, 78 patients died. The observed survival rate was significantly lower than the expected survival rate based on the general Minnesota population (P<0.001). Previous myocardial infarction (P<0.001), a history of congestive heart failure (P=0.02), and treatment with cardiac drugs after ablation (P=0.03) were independent predictors of death. Observed survival among patients without these three risk factors was similar to expected survival (P=0.43). None of the 26 patients with lone atrial fibrillation died during follow-up (37+/-27 months). The observed survival rate among patients who underwent ablation was similar to that among 229 controls with atrial fibrillation (mean age, 67+/-12 years) who received drug therapy (P=0.44). CONCLUSIONS: In the absence of underlying heart disease, survival among patients with atrial fibrillation after ablation of the atrioventricular node is similar to expected survival in the general population. Long-term survival is similar for patients with atrial fibrillation, whether they receive ablation or drug therapy. Control of the ventricular rate by ablation of the atrioventricular node and permanent pacing does not adversely affect long-term survival.

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Metadata

Authors
Ozcan, C., Jahangir, A., Friedman, P. A., Patel, P. J., Munger, T. M., Rea, R. F., Lloyd, M. A., Packer, D. L., Hodge, D. O., Hayes, D. L., Gersh, B. J., Hammill, S. C., & Shen, W.-K.
Venue
New England Journal of Medicine
Published
2001-04-05
Volume
344
Issue
14
Pages
1043-1051
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2313005132
Cited by
329
References
1
FWCI
17.01
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Long-Term Survival after Ablation of the Atrioventricular Node and Implantation of a Permanent Pacemaker in Patients with Atrial Fibrillation. https://app.cochat.ai/papers/10.1056/nejm200104053441403
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Ozcan, C., Jahangir, A., Friedman, P. A., Patel, P. J., Munger, T. M., Rea, R. F., Lloyd, M. A., Packer, D. L., Hodge, D. O., Hayes, D. L., Gersh, B. J., Hammill, S. C., & Shen, W.-K. (2001). Long-Term Survival after Ablation of the Atrioventricular Node and Implantation of a Permanent Pacemaker in Patients with Atrial Fibrillation. New England Journal of Medicine. https://doi.org/10.1056/nejm200104053441403

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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