If refractory to rate control meds and noncandidate failed rhythm control or severely symptomatic w 1 hospitalization for HF consider AVNA w pacemaker implantation tx to reduce sx physical limitations recurrent HF hospitalizations and mortality II B Creat

By rray, 15 October, 2024
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Consider consequences of lifelong pacemaker implantation esp w respect to age and comorbidities in decision making regarding benefit
Procedure has low complication rate and low long term mortality risk
No evidence supports AVNA as 1st line tx
Implant pacemaker a few weeks before ablation to ensure adequacy of pacing leads prior to ablation
Program initial pacemaker lower rate to 70 90 bpm to reduce risk of sudden death
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If refractory to rate-control meds and noncandidate/failed rhythm control, or severely symptomatic w/ >1 hospitalization for HF, consider AVNA w/ pacemaker implantation tx to reduce sx, physical limitations, recurrent HF hospitalizations, and mortality [II][B]. Creates dependence on pacing.