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Current Role of Atrioventricular Junction (AVJ) Ablation


Address for reprints: Melvin Scheinman, M.D., 500 Parnassus Ave, MUE 434, San Francisco, CA 94143-1354. Fax: 415-476-3505; e-mail:


Atrioventricular junction ablation with permanent pacemaker insertion is a highly effective treatment approach in patients with atrial fibrillation that is resistant to other treatment modalities, especially in the elderly or those with severe comorbidities. This effect likely reflects reversal of rapid ventricular rates and regularizing ventricular rates. There is increasing evidence that cardiac resynchronization therapy devices may be beneficial in selected populations after atrioventricular node ablation. The limitations of this approach include continued need for anticoagulation and lifelong pacemaker therapy.