Heart Rhythm Society

View all recommendations from this society

Released February 10, 2014

Don’t ablate the atrioventricular node in patients with atrial fibrillation when both symptoms and heart rate are acceptable controlled by well-tolerated medical therapy.

Atrioventricular node ablation and pacemaker implantation may provide benefit in some patients when rate and related symptoms cannot be controlled by medication therapy,(Class IIa, indicated) or when there is concern for possible tachycardia-induced cardiomyopathy (Class IIb, may be considered). However, according to current professional society clinical guidelines, the risks of AV node ablation outweigh the benefits among patients with no symptoms and who have appropriate rate control with well-tolerated medical therapy.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The Heart Rhythm Society (HRS) asked its standing Quality Improvement Subcommittee, comprised of twelve experienced physicians and allied professionals, to recommend five procedures that should not be performed or should be performed more rarely and only in specific circumstances. The recommendations were identified based on existing appropriate use criteria and guidelines. The HRS Health Policy Committee then reviewed the five recommendations before sending the list to the HRS Board of Trustees for final review and approval.

HRS’s disclosure and conflict of interest policy can be found at http://www.hrsonline.org/About-HRS/Heart-Rhythm-Society-Governance/Disclosure-Policy#axzz2ILTZwIkZ.


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