Atrioventricular node ablation significantly reduced healthcare utilization, including emergency department visits (-72.1%), and improved quality of life in 67.0% of patients with atrial fibrillation.
Cohort (n=248)
No
Does atrioventricular node ablation with permanent pacing improve quality of life and reduce healthcare utilization in patients with atrial fibrillation?
Atrioventricular node ablation with permanent pacing is a safe strategy that significantly reduces healthcare utilization and improves quality of life in patients with atrial fibrillation.
p-value: p=<0.001
Background: Atrioventricular node ablation (AVNA) is a class IIa, level B recommendation in the international atrial fibrillation (AF) guidelines.While its impact on symptoms is known, effects on healthcare utilization and quality of life (QoL) remain unclear.Conduction system pacing, particularly left bundle branch pacing (LBBP), may further optimize these outcomes.Objective: To assess the impact of AVNA on clinical outcomes, QoL, and healthcare utilization.Methods: Data from patients who underwent AVNA between 2019 and 2024 at a Dutch tertiary referral center were analyzed.Patients received right ventricular, biventricular, or LBBP.Outcomes included 1 clinical outcomes, 2 SF-36 QoL scores at baseline and one-year follow-up, and 3 healthcare utilization per patient-year one year prior up to one year after AVNA.Results: Of 248 patients (median age 77 years, 44.4% male), most received LBBP (62.5%), followed by biventricular (19.8%) and RV pacing (17.7%).Procedural complications were minimal (0.8%).90days mortality was 4.0% (n = 10) and one-year mortality was 10.5% (n = 26), and deaths were related to heart failure (46.2%) or non-cardiac causes (53.8%).QoL improved in 67.0% and deteriorated in 14.4%.Post-AVNA, healthcare utilization decreased significantly across all domains: outpatient clinic visits (-27.5%)emergency department visits (-72.1%),Holter analyses (-84.2%),electrocardiograms (-52.5%),ECVs (-98.2%),additional AF ablations (-83.3%), and PM/ICD upgrades (-81.8%;all p <.001). Conclusion:AVNA is a safe intervention associated with a significant reduction in healthcare utilization and improved QoL.These findings support AVNA as a valuable strategy for managing AF in an increasingly resource-constrained healthcare environment.
Scheurwater et al. (2026) conducted a cohort in Atrial fibrillation (n=248). Atrioventricular node ablation (AVNA) and permanent pacing vs. Pre-AVNA baseline was evaluated on Clinical outcomes, QoL, and healthcare utilization (p=<0.001). Atrioventricular node ablation significantly reduced healthcare utilization, including emergency department visits (-72.1%), and improved quality of life in 67.0% of patients with atrial fibrillation.