Pacing Treatment of Atrial Fibrillation Patients with Heart Failure: His Bundle Pacing Combined with Atrioventricular Node Ablation

摘要

The estimated number of individuals with atrial fibrillation (AF) in 2010 was 33.5 million globally and increases by 5 million each year. The main risk of AF includes thromboembolism, heart failure (HF), and dementia. Previous investigations have demonstrated that HF and AF coexist in approximately 13% to 27% HF patients Patients with AF and H F have a higher risk of thromboembolic events and a higher mortality compared with those with only AF or HF. Established treatment of AF includes upstream therapy of concomitant conditions, anti-coagulation, and rate/rhythm management. Nowadays the main methods to achieve rate/rhythm control include pharmacologic therapy, AF ablation, and atrioventricular node (AVN) ablation in combination with pacing therapy. How to control heart rate/ rhythm individually, however, is the most important and debatable key point. Therefore, this article reviews the methods for rate/rhythm control and focuses on the clinical application of His bundle pacing (HBP) plus AVN ablation in AF patients with HF as well as relevant skills associated with HBP lead implantation and AVN ablation.