{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T07:59:10Z","timestamp":1761983950003,"version":"build-2065373602"},"reference-count":27,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1999,4,12]]},"published-print":{"date-parts":[[1999,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To assess the incidence of arterial embolic events in patients with high rate, drug resistant, severely symptomatic paroxysmal and chronic atrial fibrillation who have undergone atrioventricular (AV) node ablation and permanent pacing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DESIGN<\/jats:title>\n                  <jats:p>Multicentre retrospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PATIENTS AND MANAGEMENT<\/jats:title>\n                  <jats:p>From May 1987 to January 1997, AV node ablation was performed in 585 severely symptomatic patients (mean (SD) age 66 (11) years) with high rate, drug resistant paroxysmal atrial fibrillation (308) or chronic atrial fibrillation (277). Lone atrial fibrillation was present in 133 patients, while the remaining 452 suffered from dilated, ischaemic, or valvar heart disease. Patients underwent VVIR (454) or DDDR (131) pacemaker implantation, after AV node ablation. Antiplatelet agents were given to 202 patients, warfarin to 187 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>During a follow up of 33.6 (24.2) months, thromboembolic events were observed in 17 patients (3%); the actuarial occurrence rates of thromboembolism were 1.1%, 3%, 4.2%, and 7.4% after one, three, five, and seven years, respectively. Among five variables, univariate analysis showed that only the presence of chronic atrial fibrillation at the time of ablation (relative risk (RR)\u2009=\u20091.8, 95% confidence interval (CI)\u2009=\u20091.02 to 3.20, p\u2009=\u20090.04) and the need for warfarin treatment (RR\u2009=\u20091.6, 95% CI 1.00 to 2.71, p\u2009=\u20090.048) were associated with a significantly higher risk of occurrence of thromboembolic events. On multivariate analysis the only predictor of embolic events during the follow up was the presence of chronic atrial fibrillation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Data from this large cohort of patients indicate a fairly low incidence (1.04% per year) of thromboembolic events after AV node ablation and pacing for drug refractory, high rate atrial fibrillation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/hrt.82.4.494","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"494-498","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Thromboembolism after atrioventricular node ablation and pacing: long term follow up"],"prefix":"10.1136","volume":"82","author":[{"given":"M","family":"Gasparini","sequence":"first","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Mantica","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Brignole","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Gianfranchi","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Menozzi","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Pizzetti","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Magenta","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Delise","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Proclemer","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Tognarin","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Ometto","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Acquati","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Mantovan","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Turco","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G M","family":"De Ferrari","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Istituto Clinico Humanitas, 56 Rozzano, 20089 Milan, Italy, \n\nbDepartment of Cardiology, Ospedali Riuniti, Lavagna, Italy, \n\ncDepartment of Cardiology, Ospedale S Maria Nuova, Reggio Emilia, Italy, \n\ndDepartment of Cardiology, Santo Spirito Hospital, Casale Monferrato, Italy, \n\ne\u201cDe Gasperis\u201d Department of Cardiology Niguarda Hospital, Milan, Italy, \n\nfDepartment of Cardiology, Ospedale Feltre, Belluno, Italy, \n\ngDepartment of Cardiology, Udine Hospital, Italy, \n\nhDepartment of"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1999,10,1]]},"reference":[{"key":"2025092001300099000_82.4.494.1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.2.469"},{"key":"2025092001300099000_82.4.494.2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S0002-9149(97)89116-3","article-title":"Atrial fibrillation, anticoagulation, and stroke.","volume":"77","author":"Morley","year":"1996","journal-title":"Am J Cardiol"},{"key":"2025092001300099000_82.4.494.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/0003-4819-116-1-1","article-title":"Predictors of thromboembolism in atrial fibrillation. I. Clinical features of patients at risk.","volume":"116","year":"1992","journal-title":"Ann Intern Med"},{"key":"2025092001300099000_82.4.494.4","first-page":"409","article-title":"Lone atrial fibrillation in the elderly. A population-based long term study [abstract].","volume":"80 (suppl II)","author":"Kopecky","year":"1989","journal-title":"Circulation"},{"key":"2025092001300099000_82.4.494.5","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(82)90196-9"},{"key":"2025092001300099000_82.4.494.6","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420130036007"},{"key":"2025092001300099000_82.4.494.7","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90394-5"},{"key":"2025092001300099000_82.4.494.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.8.2617"},{"key":"2025092001300099000_82.4.494.9","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.6.1262"},{"key":"2025092001300099000_82.4.494.10","first-page":"379","article-title":"La fulguration du fasceau de His. Mise au point \u00e0 partir de 128 cas personnels cons\u00e9cutifs.","volume":"38","author":"Clementy","year":"1989","journal-title":"Ann Cardiol Ang\u00e9iol"},{"key":"2025092001300099000_82.4.494.11","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.5.1562"},{"key":"2025092001300099000_82.4.494.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198204293061703"},{"key":"2025092001300099000_82.4.494.13","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.17.4.622"},{"key":"2025092001300099000_82.4.494.14","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420130030006"},{"key":"2025092001300099000_82.4.494.15","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1111\/j.1540-8159.1994.tb03817.x","article-title":"Long-term survival after closed-chest His-bundle ablation with direct current shock for supraventricular arrhythmias: a 10-year experience with 317 consecutive patients.","volume":"17","author":"Poquet","year":"1994","journal-title":"PACE"},{"key":"2025092001300099000_82.4.494.16","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1111\/j.1540-8159.1995.tb06982.x","article-title":"Long-term follow-up of patients treated by radiofrequency ablation of the atrioventricular junction.","volume":"18","author":"Jensen","year":"1995","journal-title":"PACE"},{"key":"2025092001300099000_82.4.494.17","first-page":"1447","article-title":"Evolution \u00e0 long terme apr\u00e8s ablation \u00e9lectrique du fasceau de His dans le traitment des tachycardies supraventriculaires.","volume":"87","author":"Canu","year":"1994","journal-title":"Arch Mal Coeur"},{"key":"2025092001300099000_82.4.494.18","first-page":"81","article-title":"Reduced embolic risk in paroxysmal and chronic AF after AV node ablation [abstract].","volume":"6 (suppl 5)","author":"Gasparini","year":"1996","journal-title":"Eur J Clin Physiol Electrophysiol"},{"key":"2025092001300099000_82.4.494.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)91200-2"},{"key":"2025092001300099000_82.4.494.20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199011293232201"},{"key":"2025092001300099000_82.4.494.21","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.2.527"},{"key":"2025092001300099000_82.4.494.22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199211123272002"},{"key":"2025092001300099000_82.4.494.23","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)92123-7"},{"key":"2025092001300099000_82.4.494.24","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90982-I"},{"key":"2025092001300099000_82.4.494.25","doi-asserted-by":"crossref","first-page":"6","DOI":"10.7326\/0003-4819-116-1-6","article-title":"Predictors of thromboembolism in atrial fibrillation. I. Clinical features of patients at risk.","volume":"116","year":"1992","journal-title":"Ann Intern Med"},{"key":"2025092001300099000_82.4.494.26","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90347-6"},{"key":"2025092001300099000_82.4.494.27","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.3.1045"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.82.4.494","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T08:30:08Z","timestamp":1758357008000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.82.4.494"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,10,1]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1999,10,1]]},"published-print":{"date-parts":[[1999,10,1]]}},"alternative-id":["10.1136\/hrt.82.4.494"],"URL":"https:\/\/doi.org\/10.1136\/hrt.82.4.494","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"type":"print","value":"1355-6037"},{"type":"electronic","value":"1468-201X"}],"subject":[],"published":{"date-parts":[[1999,10,1]]}}}