Atrial fibrillation and conduction system disease: the roles of catheter ablation and permanent pacing

Abstract

Atrial fibrillation (AF) and diseases of the cardiac conduction system frequently co-exist, and interactions between these rhythm disturbances can adversely impact patient outcomes. Concurrent AF and sinus node disease often manifests as the tachy-brady syndrome wherein the underlying sinus node dysfunction can pose a challenge to AF management. Similarly, the combination of AF and left bundle branch block increases mortality in individuals with co-existent heart failure and hampers effective delivery of cardiac resynchronization therapy. A thorough understanding of the therapeutic interventions available for these conditions, including the role of catheter ablation and permanent pacemaker programming, is crucial for optimal management in affected patients.