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Management
7.3. Atrioventricular Nodal Ablation (AVNA)
COR LOE
Recommendations
1 C-LD 1. In patients with AF and a persistently rapid ventricular response
who undergo AVNA, initial PM lower rate programming
should be 80 to 90 bpm to reduce the risk of sudden death.
2a B-R 2. In patients with AF and uncontrolled rapid ventricular
response refractory to rate-control medications (who are
not candidates for or in whom rhythm control has been
unsuccessful), AVNA can be useful to improve symptoms and
QOL.
1 B-NR 3. In patients with AF who are planned to undergo AVNA,
implantation of a PM prior to the ablation (ie, prior to or
same day of ablation) is recommended, to ensure adequacy of
the pacing leads before performing ablation.
2b C-LD 4. In patients with AF with normal EF undergoing AVNA,
conduction system pacing (CSP) of the His bundle or left
bundle area may be reasonable.
