Among rate control strategies for atrial fibrillation is atrioventricular junction ablation with ventricular pacing.Concerns about the long term safety of this procedure emerge as studies report deleterious effects of right ventricular pacing.
A cohort of patients having undergone atrioventricular node ablation and right ventricular pacing was retrospectively
studied. After 5 years of follow-up, a small decrease in left ventricular ejection fraction was observed and 19% of patients
suffered at least one episode of decompensated heart failure, often in association with contributing cardiovascular comorbidities.
Atrioventricular node ablation with pacing can still safely be used in selected patients to control rate in atrial fibrillation.