Wang et al identified risk factors for sudden death after atrioventricular junction ablation and pacemaker implantation. These can help to identify a patient who may benefit from more aggressive management. The authors are from Wuxi People's Hospital, Mayo Clinic and Thomas Jefferson University.

Patient selection: atrioventricular junction ablation and pacemaker insertion for atrial fibrillation


Risk factors for overall mortality:

(1) congestive heart failure

(2) NYHA functional class III or IV

(3) chronic renal failure

(4) nonsustained ventricular tachycardia


Risk factors for sudden death:

(1) dilated cardiomyopathy

(2) mitral stenosis

(3) narrow QRS complex prior to procedure

(4) right bundle branch block prior to procedure


Sudden death was not seen in any patient with pre-existing left bundle branch block.

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