ABLATION OF THE AV NODE IN A PATIENT WITH SEVERE HEART FAILURE IN NYHAFUNCTIONAL CLASS IV, ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE,AND IMPLANTED CARDIAC RESYNCHRONIZATION THERAPY DEVICE WITH A LOWPERCENTAGE OF EFFECTIVE BIVENTRICULAR PACING.

Abstract

Pre-existing atrioventricular block in patients with ventricular dyssynchrony, suppressed left ventricular contractility, implanted cardiac resynchronization therapy (CRT) system, and poor heart rate control lead to a low percentage of biventricular stimulation and a poor response to therapy. Ablation of the AV junction renders patients dependent on cardiac pacing and enables the achievement of approximately 100% effective dual-chamber stimulation, which improves response to resynchronization therapy.