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Clinical Outcomes After Ablation and Pacing Therapy for Atrial Fibrillation: A Meta-Analysis
Abstract
BACKGROUND: Radiofrequency ablation of the atrioventricular node and permanent pacing are used for symptomatic relief in patients with medically refractory atrial fibrillation. In this study, meta-analysis was used to clarify clinical outcomes and survival after ablation and pacing therapy using data from the published literature. METHODS AND RESULTS: We used 21 studies with a total of 1181 patients in the meta-analysis. All patients had medically refractory atrial tachyarrhythmias, primarily atrial fibrillation (97%). Nineteen measures of clinical outcome, encompassing quality of life, ventricular function, exercise duration, and healthcare use, were derived from the studies. The meta-analysis demonstrated significant improvement after ablation and pacing therapy in all outcome measures except fractional shortening, which demonstrated a trend toward improvement (P=0.08). Ejection fraction did show significant improvement (P<0.001). The calculated 1-year total and sudden death mortality rates after ablation and pacing therapy were 6.3% and 2.0%, respectively. CONCLUSIONS: Ablation and pacing therapy improves a broad range of clinical outcomes for patients with medically refractory atrial fibrillation. The calculated 1-year mortality rates after this therapy are low and comparable with medical therapy.
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“The procedure does not worsen LV function 567 and may even improve LVEF in selected patients.[568][569][570]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [569]
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Metadata
- Authors
- Wood, M. A., Brown-Mahoney, C., Kay, G. N., & Ellenbogen, K. A.
- Affiliations
- University of Minnesota (US)
- Venue
- Circulation
- Published
- 2000-03-14
- Volume
- 101
- Issue
- 10
- Pages
- 1138-1144
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2069728923
- Cited by
- 476
- References
- 43
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 19 · 2021: 16 · 2020: 7 · 2019: 5 · 2018: 11 · 2017: 9 · 2016: 15 · 2015: 6 · 2014: 15 · 2013: 18 · 2012: 26
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- atrial fibrillation, radiofrequency catheter ablation, atrioventricular node ablation, permanent pacemaker, mortality, sudden death, quality of life, ejection fraction, ventricular function, health care utilization
- MeSH terms
- Aged, Atrial Fibrillation, Cardiac Pacing, Artificial, Clinical Trials as Topic, Female, Humans, Male, Middle Aged, Survival Analysis, Treatment Outcome, Catheter Ablation
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