Abstract
OBJECTIVE: To evaluate exercise capacity of patients with chronic atrial fibrillation in whom His bundle ablation followed by ventricular rate response pacing (VVIR) was carried out because of drug refractoriness. DESIGN: Prospective study. PATIENTS: 25 consecutive patients, all with chronic symptomatic drug refractory atrial fibrillation, underwent His bundle ablation. Before this intervention all patients were on antiarrhythmic drugs to attain acceptable heart rate control and to relief symptoms. MAIN OUTCOME MEASURES: Exercise capacity, including measurements of VO2, was examined before and after a mean interval of seven months following His bundle ablation. RESULTS: Exercise capacity after His bundle ablation increased from a mean of 109 (SD 49) W to 118 (46) W (P < 0.002), but VO2 at peak exercise did not change significantly. Maximum exercise capacity was achieved with a significantly lower maximum driven heart rate than the spontaneous heart rate before ablation. CONCLUSIONS: Exercise capacity of patients who underwent His bundle ablation followed by VVIR pacing remained unchanged or improved during a mean follow up of seven months. Larger patient populations with longer follow up are necessary to examine determinants of improved exercise capacity.
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Selected References
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- Abrahamsen A. M., Barvik S., Aarsland T., Dickstein K. Rate responsive cardiac pacing using a minute ventilation sensor. Pacing Clin Electrophysiol. 1993 Aug;16(8):1650–1655. doi: 10.1111/j.1540-8159.1993.tb01035.x. [DOI] [PubMed] [Google Scholar]
- Brignole M., Gianfranchi L., Menozzi C., Bottoni N., Bollini R., Lolli G., Oddone D., Gaggioli G. Influence of atrioventricular junction radiofrequency ablation in patients with chronic atrial fibrillation and flutter on quality of life and cardiac performance. Am J Cardiol. 1994 Aug 1;74(3):242–246. doi: 10.1016/0002-9149(94)90364-6. [DOI] [PubMed] [Google Scholar]
- Cruz F. E., Cheriex E. C., Smeets J. L., Atié J., Peres A. K., Penn O. C., Brugada P., Wellens H. J. Reversibility of tachycardia-induced cardiomyopathy after cure of incessant supraventricular tachycardia. J Am Coll Cardiol. 1990 Sep;16(3):739–744. doi: 10.1016/0735-1097(90)90368-y. [DOI] [PubMed] [Google Scholar]
- Edner M., Caidahl K., Bergfeldt L., Darpö B., Edvardsson N., Rosenqvist M. Prospective study of left ventricular function after radiofrequency ablation of atrioventricular junction in patients with atrial fibrillation. Br Heart J. 1995 Sep;74(3):261–267. doi: 10.1136/hrt.74.3.261. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Elborn J. S., Stanford C. F., Nicholls D. P. Reproducibility of cardiopulmonary parameters during exercise in patients with chronic cardiac failure. The need for a preliminary test. Eur Heart J. 1990 Jan;11(1):75–81. doi: 10.1093/oxfordjournals.eurheartj.a059596. [DOI] [PubMed] [Google Scholar]
- Grogan M., Smith H. C., Gersh B. J., Wood D. L. Left ventricular dysfunction due to atrial fibrillation in patients initially believed to have idiopathic dilated cardiomyopathy. Am J Cardiol. 1992 Jun 15;69(19):1570–1573. doi: 10.1016/0002-9149(92)90705-4. [DOI] [PubMed] [Google Scholar]
- Heinz G., Siostrzonek P., Kreiner G., Gössinger H. Improvement in left ventricular systolic function after successful radiofrequency His bundle ablation for drug refractory, chronic atrial fibrillation and recurrent atrial flutter. Am J Cardiol. 1992 Feb 15;69(5):489–492. doi: 10.1016/0002-9149(92)90991-7. [DOI] [PubMed] [Google Scholar]
- Kay G. N., Bubien R. S., Epstein A. E., Plumb V. J. Effect of catheter ablation of the atrioventricular junction on quality of life and exercise tolerance in paroxysmal atrial fibrillation. Am J Cardiol. 1988 Oct 1;62(10 Pt 1):741–744. doi: 10.1016/0002-9149(88)91214-3. [DOI] [PubMed] [Google Scholar]
- Langberg J. J., Chin M. C., Rosenqvist M., Cockrell J., Dullet N., Van Hare G., Griffin J. C., Scheinman M. M. Catheter ablation of the atrioventricular junction with radiofrequency energy. Circulation. 1989 Dec;80(6):1527–1535. doi: 10.1161/01.cir.80.6.1527. [DOI] [PubMed] [Google Scholar]
- Lau C. P., Antoniou A., Ward D. E., Camm A. J. Reliability of minute ventilation as a parameter for rate responsive pacing. Pacing Clin Electrophysiol. 1989 Feb;12(2):321–330. doi: 10.1111/j.1540-8159.1989.tb02665.x. [DOI] [PubMed] [Google Scholar]
- Mond H., Strathmore N., Kertes P., Hunt D., Baker G. Rate responsive pacing using a minute ventilation sensor. Pacing Clin Electrophysiol. 1988 Nov;11(11 Pt 2):1866–1874. doi: 10.1111/j.1540-8159.1988.tb06322.x. [DOI] [PubMed] [Google Scholar]
- Morady F., Calkins H., Langberg J. J., Armstrong W. F., de Buitleir M., el-Atassi R., Kalbfleisch S. J. A prospective randomized comparison of direct current and radiofrequency ablation of the atrioventricular junction. J Am Coll Cardiol. 1993 Jan;21(1):102–109. doi: 10.1016/0735-1097(93)90723-e. [DOI] [PubMed] [Google Scholar]
- Tjahja I. E., Reddy H. K., Janicki J. S., Weber K. T. Evolving role of cardiopulmonary exercise testing in cardiovascular disease. Clin Chest Med. 1994 Jun;15(2):271–285. [PubMed] [Google Scholar]
- Twidale N., Sutton K., Bartlett L., Dooley A., Winstanley S., Heddle W., Hassam R., Koutsounis H. Effects on cardiac performance of atrioventricular node catheter ablation using radiofrequency current for drug-refractory atrial arrhythmias. Pacing Clin Electrophysiol. 1993 Jun;16(6):1275–1284. doi: 10.1111/j.1540-8159.1993.tb01714.x. [DOI] [PubMed] [Google Scholar]
- Weber K. T., Kinasewitz G. T., Janicki J. S., Fishman A. P. Oxygen utilization and ventilation during exercise in patients with chronic cardiac failure. Circulation. 1982 Jun;65(6):1213–1223. doi: 10.1161/01.cir.65.6.1213. [DOI] [PubMed] [Google Scholar]
