Prospective, randomized study of atrioventricular node ablation and mode-switching, dual chamber pacemaker implantation using two different algorithms in patients with paroxysmal atrial fibrillation

Symptomatic patients who had tried two or more drugs for PAF were randomized to continue medical therapy (n=19) or to undergo atrioventricular (AV) node ablation and implantation of a DDDR/mode-switching pacemaker (subrandomized to either a Medtronic Thera (n=18) or a Vitatron Diamond (n=19)). Follow-up was at three 6 week intervals with quality of life questionnaires (Psychological General Well Being [PGWB], McMaster Health Index [MHI] , cardiac symptom score [CSC] ), exercise testing, echocardiography, and Holter monitoring. Paced patients were ‘run in’ during the first period and were then randomized to either DDDR/mode-switching or VVIR for the next period and crossed over to the other mode for the last 6 weeks.