Complete atrioventricular (AV) block only occurs in a small amount of patients undergoing ventricular arrhythmias (VA) ablation and does not appear to be associated with worse outcome of a combined endpoint of heart failure and mortality, according to research presented at AHA 2018 in Chicago, IL, and published Nov. 5 in JACC: Clinical Electrophysiology.

Tomofumi Nakamura, MD, PhD, et al., looked at 1,418 patients who had catheter ablation for drug-refractory ventricular arrhythmias. Results showed that 21 patients developed AV block. VAs recurred in 33 percent of patients with AV block, 17 percent in the 1:2 propensity score–matched control group, and 35 percent in patients with pre-existing AV block before ablation.

In addition, the composite outcome of heart failure hospitalization, heart transplantation, or death occurred in 29 percent of patients with AV block, 17 percent in the control group, and 45 percent in patients with pre-existing AV block before ablation.

The authors conclude that "for patients with drug-refractory VA, the risk of heart block from ablation may be adequately offset if VAs are controlled." Moving forward, "further studies are needed to address the influence of persistent bundle branch block in patients, with impaired LV systolic function are also thought to be affected. Studies to evaluate outcomes during the long-term follow-up period are also needed."

Clinical Topics: Arrhythmias and Clinical EP, Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Implantable Devices, EP Basic Science, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Cardiac Surgery and Arrhythmias, Cardiac Surgery and Heart Failure, Acute Heart Failure, Heart Transplant

Keywords: AHA18, AHA Annual Scientific Sessions, Atrioventricular Block, Bundle-Branch Block, Propensity Score, Control Groups, Arrhythmias, Cardiac, Catheter Ablation, Heart Failure, Heart Transplantation, Electrophysiology

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