Simultaneous atrioventricular node ablation and leadless pacemaker implantation☆☆☆

Introduction The ablate-and-pace technique is a well-established method to treat patients with persistent and paroxysmal atrial fibrillation with poor rate control on medical therapy.1 The technique represents a class IIa indication to control heart rates when pharmacologic therapy is insufficient or intolerable.2 As many of these patients are in permanent atrial fibrillation, they frequently require only single-chamber ventricular pacing after an atrioventricular (AV) node ablation. With the advent of transcatheter pacing systems, single-chamber pacemakers can now be implanted percutaneously without the need for leads or creation of a pocket or transvenous leads. Leadless pacemakers have a lower complication rate compared with that of traditional pacemakers in a historical control population.3