INTRODUCTION
Right‐sided atrioventricular node ablation, cardiac arrhythmia
ATRIAL FIBRILLATION (AF), CARDIAC ARRHYTHMIA
Atrial fibrillation (AF) is the most common cardiac arrhythmia with 8.5% prevalence in men and 7.1% prevalence in women over the age of 55.Catheter ablation of the atrioventricular node is an accepted and highly effective treatment strategy in patients with AF to improve symptoms and to achieve 100% cardiac resynchronization therapy.Right‐sided atrioventricular node ablation is the initial conventional approach; however, up to 18.5% of patients require transferring to a left‐sided approach or otherwise have a challenging procedure with multiple radiofrequency (RF) energy applications and a high radiation exposure.Performing left‐sided ablation as the initial approach in prospective studies has been shown to have a higher success rate, reduced procedure time, and less radiation exposure than the right‐sided approach.However, the right‐ and left‐sided approaches have not previously been directly compared in a randomized trial, raising the possibility of selection bias accounting for the results previously reported. Additionally, there is now potentially a greater clinical requirement to perform left‐sided AV node ablation to avoid displacing or damaging previously inserted pacemaker leads.This study compares the success of retrograde aortic left‐ and right‐sided approaches to ablation of the atrioventricular node in a randomized controlled trial.