Evidence map›Paper›PMID 40195231›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025

Long-term outcomes of pace-and-ablate strategy in patients with atrial fibrillation.

Johan van Koll, Madelon D E A Engels, Jesse H J Rijks, Madelon Salari, Jelle Luijten, Joost Lumens, Vanessa P M van Empel, Sjoerd W Westra, Antonius M W van Stipdonk, Theo A R Lankveld and 6 more

Abstract read
In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Johan van KollDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Madelon D E A EngelsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Jesse H J RijksDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Madelon SalariDepartment of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Jelle LuijtenDepartment of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Joost LumensDepartment of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Vanessa P M van EmpelDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Sjoerd W WestraDepartment of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Antonius M W van StipdonkDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Theo A R LankveldDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Sevasti M ChaldoupiDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Jacqueline JozaDepartment of Medicine, Mcgill University Health Center, Montreal, QC, Canada.
Rypko J BeukemaDepartment of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Justin G L M LuermansDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Dominik K LinzDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Kevin VernooyDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands. kevin.vernooy@mumc.nl.ORCID http://orcid.org/0000-0002-8818-5964

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe pace-and-ablate strategy is second -line therapy to obtain rate control in patients with persistent symptomatic atrial fibrillation (AF) when other treatment options fail. This study aims to evaluate long-term effects on clinical outcomes following pace-and-ablate strategy in AF patients.

methodsThis retrospective study includes patients who underwent successful pacemaker implantation (right ventricular pacing (RVP) or cardiac re-synchronization therapy (CRT)) followed by atrioventricular node ablation (AVNA) between 2010 and 2020. Patients were treated according to the prevailing guidelines. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization (HFH). Secondary endpoints were individual outcomes of all-cause mortality, HFH, and left-ventricular ejection fraction (LVEF) change.

resultsTwo hundred ninety-eight patients were included, 162 undergoing RVP, and 136 receiving CRT, with a median follow-up of 5.8 years [4.1-8.0]. The primary endpoint occured in 47% of the RVP group and 49% of the CRT group (p = 0.206). All-cause mortality occurred in 36% of the RVP group and in 45% of the CRT group (p = 0.005). HFH occurred in 22% of the RVP group and in 15% of the CRT group (p = 0.328), with 17(10%) upgrades to CRT in the RVP group. Median LVEF in the RVP group remained stable (56% [49-60] to 53% [43-57]; p = 0.081), while it improved in the CRT group (31% [22-38] to 43% [32-51]; p < 0.001).

conclusionMortality and HFH in patients with AF managed through a pace-and-ablate strategy are high. Reassuringly, LVEF deterioration requiring upgrade to CRT is uncommon in patients undergoing RVP with normal baseline LVEF before AVNA. CRT improves LVEF in patients with reduced LVEF before AVNA.

Indexed as

Atrial FibrillationCardiac Resynchronization TherapyCatheter AblationAgedFemaleHeart FailureHumansMaleMiddle AgedRetrospective StudiesStroke VolumeTreatment OutcomeAtrial fibrillationAtrioventricular node ablationCardiac resynchronization therapyHeart failureRight ventricular pacingSurvival analysis

Identifiers

PMID40195231
PMCPMC12436554

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.