Case Selection for Cardiac Resynchronization in Atrial Fibrillation

Cleland, John G.F.; Keshavarzi, Freidoon; Pellicori, Pierpaolo; Dicken, Benjamin

doi:10.1016/j.hfc.2013.07.001

Cited by 14 publications

(11 citation statements)

References 94 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several trials show that bi-ventricular pacing is superior to right ventricular pacing after AV node ablation. 75 This may reflect the deleterious effects of right ventricular pacing rather than any benefit of bi-ventricular pacing. The landmark trials all required patients to be in sinus rhythm.…”

Section: Consensus Recommendationmentioning

confidence: 99%

Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology

Seferović

Ponikowski

Anker

et al. 2019

European J of Heart Fail

Self Cite

542

422

View full text Add to dashboard Cite

The European Society of Cardiology (ESC) has published a series of guidelines on heart failure (HF) over the last 25 years, most recently in 2016. Given the amount of new information that has become available since then, the Heart Failure Association (HFA) of the ESC recognized the need to review and summarise recent developments in a consensus document. Here we report from the HFA workshop that was held

show abstract

Section: Consensus Recommendationmentioning

confidence: 99%

Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology

Seferović

Ponikowski

Anker

et al. 2019

European J of Heart Fail

Self Cite

542

422

View full text Add to dashboard Cite

show abstract

“… 17 The use of CRT-D or CRT-P in clinical practice is an important question with significant implications in terms of costs, 18 as well as device-related complications. 19 , 20 …”

Section: Introductionmentioning

confidence: 99%

Causes-of-death analysis of patients with cardiac resynchronization therapy: an analysis of the CeRtiTuDe cohort study

et al. 2015

View full text Add to dashboard Cite

AimsThe choice of resynchronization therapy between with (CRT-D) and without (CRT-P) a defibrillator remains a contentious issue. Cause-of-death analysis among CRT-P, compared with CRT-D, patients could help evaluate the extent to which CRT-P patients would have additionally benefited from a defibrillator in a daily clinical practice.Methods and resultsA total of 1705 consecutive patients implanted with a CRT (CRT-P: 535 and CRT-D: 1170) between 2008 and 2010 were enrolled in CeRtiTuDe, a multicentric prospective follow-up cohort study, with specific adjudication for causes of death at 2 years. Patients with CRT-P compared with CRT-D were older (P < 0.0001), less often male (P < 0.0001), more symptomatic (P = 0.0005), with less coronary artery disease (P = 0.003), wider QRS (P = 0.002), more atrial fibrillation (P < 0.0001), and more co-morbidities (P = 0.04). At 2-year follow-up, the annual overall mortality rate was 83.80 [95% confidence interval (CI) 73.41–94.19] per 1000 person-years. The crude mortality rate among CRT-P patients was double compared with CRT-D (relative risk 2.01, 95% CI 1.56–2.58). In a Cox proportional hazards regression analysis, CRT-P remained associated with increased mortality (hazard ratio 1.54, 95% CI 1.07–2.21, P = 0.0209), although other potential confounders may persist. By cause-of-death analysis, 95% of the excess mortality among CRT-P subjects was related to an increase in non-sudden death.ConclusionWhen compared with CRT-D patients, excess mortality in CRT-P recipients was mainly due to non-sudden death. Our findings suggest that CRT-P patients, as currently selected in routine clinical practice, would not potentially benefit with the addition of a defibrillator.

show abstract

“…In contrast to patients in sinus rhythm, reduction in ventricular rate below a range of 70-90bpm at rest may be harmful for patients in atrial fibrillation. For patients with atrial fibrillation, ivabradine is not thought to be effective and there is little evidence to support CRT (115)(116)(117).…”

Section: Atrial Fibrillation (Figure 4)mentioning

confidence: 99%

“…However, CRT is more than just bi-ventricular pacing. Coordinated atrial function may be responsible for much of its benefit, in which case restoration of electrical and mechanical sinus rhythm might be essential (117,182). The ESC CRT-II survey shows that large variations in clinical practice exist in countries belonging to the European Society of Cardiology (184).…”

Section: Devices and Transplantation (700 Words)mentioning

confidence: 99%