December 2024 Br J Cardiol 2024;31:160 doi:10.5837/bjc.2024.054
James Mannion, Niall Leahy, Kathryn Hong, Sean Esmonde
Abstract
Introduction
Atrioventricular nodal (AVN) ablation with permanent pacemaker implantation – ‘pace and ablate’ – may be considered for patients with symptomatic atrial fibrillation (AF) for whom a rhythm control strategy has been unsuccessful.1 Guidelines published by the European Society of Cardiology (ESC) in 2020 recommended this strategy with class IIA strength.2 The decision by physicians to perform this procedure has been counterbalanced by the risk of pacemaker-induced cardiomyopathy (PICM) and heart failure due to excessive right ventricular (RV) pacing. Conduction-system pacing and left bundle branch area pacing (LBBAP) are st
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