{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T17:43:10Z","timestamp":1775929390973,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In the evolving treatment of atrial fibrillation (AF), atrioventricular (AV) node ablation is being reconsidered as an early option for patients with inadequate AF control and limited cure potential. Although interest in physiological pacing is growing, concerns about the long\u2010term safety of permanent His bundle pacing (p\u2010HBP) persist. Our current study aims to evaluate the long\u2010term outcomes of patients who underwent AV node ablation and p\u2010HBP, focusing on left ventricular ejection fraction (LVEF), NYHA class, readmissions, and pacing parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This descriptive observational study involved patients with uncontrolled permanent atrial arrhythmias who were eligible for heart rate (HR) control (between January 2019 and July 2020) and underwent p\u2010HBP and AV node ablation, followed during a near 4\u2010year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We conducted a long\u2010term follow\u2010up study with a median duration of 47\u00a0months on 32 patients who received p\u2010HBP followed by AV node ablation. The average age was 77\u00a0years, predominantly female (65.6%), with a high prevalence of hypertension (90.6%). The main indications for ablation were uncontrolled AF (59.4%) and atypical atrial flutter (37.5%). At baseline, the median LVEF was 60%. Notably, LVEF improved significantly from 45% to 50% in those with reduced baseline function (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). NYHA class improvements were also observed over time. The His thresholds remained similar during long\u2010term follow\u2010up, being 1.25\u00a0V at 0.4\u00a0ms (1.25\u20132.4\u00a0V at 0.4\u00a0ms) before AV node ablation and 1.30\u00a0V at 0.4\u00a0ms (0.75\u20132.25\u00a0V at 0.4\u00a0ms),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.89, at long\u2010term follow\u2010up. The impedances remained stable. No complications related to the pacemaker occurred. Number of medications per patient for HR control significantly decreased from 1.6 to 0.37 (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), while hospital admissions for tachyarrhythmias dropped markedly. There was one death during the follow\u2010up due to cancer, but conclusions regarding mortality are limited by the small sample size.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AV node ablation and p\u2010HBP significantly improve functional class and LVEF, with benefits maintained over time. Patients experience fewer emergency visits and reduced HR medication. Pacing parameters remained stable during long\u2010term follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70000","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T03:18:38Z","timestamp":1750303118000},"page":"799-806","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010Term Results of Atrioventricular Node Ablation After His Bundle Pacing in Uncontrolled Atrial Tachyarrhythmias"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7114-973X","authenticated-orcid":false,"given":"Mar\u00eda Teresa","family":"Moraleda\u2010Salas","sequence":"first","affiliation":[{"name":"Arrhythmia Unit Department of Cardiology Hospital Juan Ramon Jimenez  Huelva Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ane","family":"Erkoreka\u2010Gasituaga","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Juan Ramon Jimenez  Huelva Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Perea\u2010Alfaro","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Juan Ramon Jimenez  Huelva Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1856-8521","authenticated-orcid":false,"given":"Irene","family":"Esteve\u2010Ruiz","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit Department of Cardiology Hospital Juan Ramon Jimenez  Huelva Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1lvaro","family":"Arce\u2010Le\u00f3n","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit Department of Cardiology Hospital Juan Ramon Jimenez  Huelva Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Miguel","family":"Carre\u00f1o\u2010Lineros","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit Department of Cardiology Hospital Juan Ramon Jimenez  Huelva Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4412-6580","authenticated-orcid":false,"given":"Emilio","family":"Amigo\u2010Otero","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Juan Ramon Jimenez  Huelva Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda del Mar","family":"Moraleda\u2010Salas","sequence":"additional","affiliation":[{"name":"Primary Care Department  Albacete Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Camacho\u2010Freire","sequence":"additional","affiliation":[{"name":"Hemodynamics Unit Department of Cardiology Hospital Juan Ramon Jimenez  Huelva 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