AV Junction Ablation and CRT vs. Pharmacological Rate Control in Atrial Fibrillation

In patients with atrial fibrillation (AF), the mortality benefit of pharmacological rate control has been considered roughly equivalent to that of more-aggressive treatments such as rhythm control or ablate-and-pace (i.e., atrioventricular [AV] junction ablation with placement of a cardiac resynchronization therapy [CRT] device), although rhythm control is showing better results than rate control in the latest randomized, controlled trials. Ablate-and-pace is an AF treatment strategy largely utilized in highly symptomatic individuals. In the APAF-CRT trial (NCT02137187), researchers found that this strategy decreased heart failure hospitalizations compared with pharmacological rate control in patients with severely symptomatic permanent AF …