{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:35:54Z","timestamp":1787016954549,"version":"build-2736575974"},"reference-count":26,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1997,12,31]]},"published-print":{"date-parts":[[1998,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the effect of atrioventricular node ablation and implantation of a dual chamber, mode switching pacemaker on quality of life, exercise capacity, and left ventricular systolic function in patients with drug refractory paroxysmal atrial fibrillation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>18 consecutive patients with drug refractory paroxysmal atrial fibrillation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Quality of life was assessed before and after the procedure using the psychological general wellbeing index (PGWB), the McMaster health index (MHI), and a visual analogue scale for cardiac symptoms. Nine of the patients also underwent symptom limited exercise tests and echocardiography to assess left ventricular systolic function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The procedure allowed a reduction in antiarrhythmic drug treatment (p\u2009&lt;\u20090.01). PGWB and symptom scores improved (p\u2009&lt;\u20090.01) but the MHI score did not change. Left ventricular systolic function and exercise capacity were unchanged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Atrioventricular node ablation and implantation of a DDDR\/MS pacemaker is effective treatment for refractory paroxysmal atrial fibrillation, producing improved quality of life while allowing a reduction in drug burden. The popularity of the treatment is justified, but further studies are needed to determine optimum timing of intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/hrt.79.6.543","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"543-547","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":45,"title":["Atrioventricular nodal ablation and implantation of mode switching dual chamber pacemakers: effective treatment for drug refractory paroxysmal atrial fibrillation"],"prefix":"10.1136","volume":"79","author":[{"given":"H J","family":"Marshall","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z I","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M J","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M D","family":"Gammage","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1998,6,1]]},"reference":[{"key":"2025092101430480000_79.6.543.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198204293061703"},{"key":"2025092101430480000_79.6.543.2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)90824-Z"},{"key":"2025092101430480000_79.6.543.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1982.03330070039027"},{"key":"2025092101430480000_79.6.543.4","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90516-C"},{"key":"2025092101430480000_79.6.543.5","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1111\/j.1540-8159.1994.tb03770.x","article-title":"A new auto mode witch algorithm for supraventricular arrhythmias.","volume":"17","author":"Levine","year":"1994","journal-title":"PACE"},{"key":"2025092101430480000_79.6.543.6","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1111\/j.1540-8159.1994.tb03771.x","article-title":"Initial experience with mode switching in a dual sensor, dual chamber pacemaker in patients with paroxysmal atrial tachyarrhythmias.","volume":"17","author":"Den Dulk","year":"1994","journal-title":"PACE"},{"key":"2025092101430480000_79.6.543.7","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1111\/j.1540-8159.1994.tb03772.x","article-title":"Initial experience with a new algorithm for automatic mode switching from DDDR to DDIR mode.","volume":"17","author":"Ovsyshcher","year":"1994","journal-title":"PACE"},{"key":"2025092101430480000_79.6.543.8","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1111\/j.1540-8159.1994.tb03773.x","article-title":"The \u201cautomatic mode switch\u201d function in successive generations of minute ventilation sensing dual chamber rate responsive pacemakers.","volume":"17","author":"Provenier","year":"1994","journal-title":"PACE"},{"key":"2025092101430480000_79.6.543.9","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(88)91214-3"},{"key":"2025092101430480000_79.6.543.10","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1111\/j.1540-8159.1994.tb03816.x","article-title":"Radiofrequency catheter ablation and modulation of the atrioventricular node in patients with atrial fibrillation.","volume":"17","author":"Mennozzi","year":"1994","journal-title":"PACE"},{"key":"2025092101430480000_79.6.543.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(96)90528-1"},{"key":"2025092101430480000_79.6.543.12","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.74.3.261"},{"key":"2025092101430480000_79.6.543.13","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90982-I"},{"key":"2025092101430480000_79.6.543.14","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90394-5"},{"key":"2025092101430480000_79.6.543.15","unstructured":"Chambers LW Depuy HJ (1984) Assessment of quality of life in clinical trials of cardiovascular therapies. 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