Long-term experience of atrioventricular node ablation in patients with refractory atrial arrhythmias

  • Kevin Willy
  • Florian Reinke
  • Christian Ellermann
  • Patrick Leitz
  • Kristina Wasmer
  • Julia Köbe
  • Philipp S. Lange
  • Simon Kochhäuser
  • Dirk Dechering
  • Lars Eckardt
  • Gerrit FrommeyerEmail author
Original Article


Atrial fibrillation and other atrial tachyarrhythmias are increasing with age and concomitant morbidity. First options in symptomatic patients are drug treatment and catheter ablation. Nevertheless, a considerable number of patients suffer from refractory atrial tachyarrhythmias despite treatment. Atrioventricular node ablation (AVNA) may be helpful in many of these patients. Therefore, we investigated AVNA patients with a long-term follow-up. We enrolled 82 patients with a follow-up longer than 1 year receiving AVNA for drug- and ablation-resistant atrial tachyarrhythmias (AA) in a retrospective manner. Mean follow-up duration was 48 ± 24 months. 50% of the patients initially received AVNA to optimize biventricular pacing in cardiac resynchronization therapy, the other 50% because of refractory symptomatic tachyarrhythmias. Persistent AV block was achieved in every patient. Symptom relief and patient satisfaction were high during follow-up. Due to system upgrades there were 63% of patients with a biventricular system during follow-up. In these patients, left-ventricular ejection fraction (LV-EF) increased by 7% (42–49%) after ablation. AVNA is effective in increasing biventricular pacing as well as for symptom relief in patients with refractory atrial tachyarrhythmias. AVNA should be considered as a valuable option in patients with refractory atrial tachyarrhythmias lacking other treatment options.


Atrioventricular node ablation Atrial fibrillation Cardiac pacing 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Kevin Willy
    • 1
  • Florian Reinke
    • 1
  • Christian Ellermann
    • 1
  • Patrick Leitz
    • 1
  • Kristina Wasmer
    • 1
  • Julia Köbe
    • 1
  • Philipp S. Lange
    • 1
  • Simon Kochhäuser
    • 1
  • Dirk Dechering
    • 1
  • Lars Eckardt
    • 1
  • Gerrit Frommeyer
    • 1
    Email author
  1. 1.Clinic for Cardiology II: ElectrophysiologyUniversity Hospital MünsterMünsterGermany

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