Comparison of response to cardiac resynchronization therapy in patients with sinus rhythm versus chronic atrial fibrillation

Molhoek, Sander G.; Bax, Jeroen J.; Bleeker, Gabe B.; Boersma, Eric; Erven, Lieselot van; Steendijk, Paul; Wall, Ernst E. van der; Schalij, Martin J.

doi:10.1016/j.amjcard.2004.08.028

Cited by 181 publications

(120 citation statements)

References 13 publications

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“…13,14 There were 221 nonresponders reported in a total of 6 studies. 6,8,11,14,22,25 The overall mean proportion of responders was 63.6% (range, 48.5%-84.6%) and 46.6% (range, 18.7%-58.8%) among patients with and without AVN ablation, respectively. RRs were calculated using the number of nonresponders among AVNA + and AVNA − patients, respectively; the RR of CRT nonresponse for AVNA + vs AVNA − was 0.67 (95% CI: 0.43 to 1.04, P = 0.08, I 2 = 73%).…”

Section: Clinical Response To Crtmentioning

confidence: 98%

See 1 more Smart Citation

Effects of Atrioventricular Nodal Ablation on Permanent Atrial Fibrillation Patients With Cardiac Resynchronization Therapy: A Systematic Review and Meta‐analysis

Yin

Wang

et al. 2014

Clinical Cardiology

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Cardiac resynchronization therapy (CRT) is a well-established therapy for patients with heart failure (HF) and wide QRS configuration, especially for those in sinus rhythm. However, for those with permanent AF, atrioventricular nodal (AVN) ablation use remains under debate. Our objective was to evaluate clinical outcomes and mortality of AVN ablation in HF patients with permanent AF receiving CRT. Electronic publication database and reference lists through October 1, 2013 were searched. Observational cohort studies comparing CRT patients with AF who received either AVN ablation or medical therapy were selected. Outcomes included mortality, CRT nonresponse, changes in left ventricular remodeling, and functional outcomes, such as New York Heart Association (NYHA) functional class, quality of life, and 6-minute hall walk distance. Of 1641 reports identified, 13 studies with 1256 patients were included. Among patients with permanent AF and insufficient biventricular pacing (<90%), those who had undergone AVN ablation compared to those who did not had numerically lower all-cause mortality (risk ratio [RR]: 0.63, 95% confidence interval [CI]: 0.42 to 0.96, P = 0.03) and significantly lower nonresponse to CRT (RR: 0.41, 95% CI: 0.31 to 0.54, P < 0.00001). Furthermore, AVN ablation was not associated with additional improvements on left ventricular ejection fraction, NYHA functional class, 6-minute hall walking distance, and quality of life. In patients with permanent AF undergoing CRT, AVN ablation tended to reduce mortality potentially and improved clinical response when it was applied to patients with inadequate biventricular pacing (<90%). Randomized controlled trials are needed to further address the efficacy of AVN ablation among this population.

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Section: Clinical Response To Crtmentioning

confidence: 98%

“…Response to CRT was defined as ≥1 class improvement in NYHA and survival over 6 to 12 months, 6,11,13,14,25 ≥10% reduction in left ventricular end-systolic volume, 8,13 and a 10% improvement in 6MWT. 13,14 There were 221 nonresponders reported in a total of 6 studies.…”

Section: Clinical Response To Crtmentioning

confidence: 99%

Effects of Atrioventricular Nodal Ablation on Permanent Atrial Fibrillation Patients With Cardiac Resynchronization Therapy: A Systematic Review and Meta‐analysis

Yin

Wang

et al. 2014

Clinical Cardiology

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“…Es importante subrayar que el uso de ablación del nodo AV varía mucho entre los diferentes estudios (del 15% 97 al 100% 90 ). La decisión de realizar la ablación del nodo AV continúa siendo objeto de debate, pero la mayoría de los estudios demuestran el efecto beneficioso de ampliar los efectos de la TRC [98][99][100][101][102] . En estos estudios, los pacientes con FA sin ablación del nodo AV tuvieron una respuesta a la TRC peor que los pacientes con SR o FA con ablación del nodo AV.…”

Section: Insuficiencia Cardiaca Qrs Intrínseco ≥ 120 Ms Y Fracción Dunclassified

2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy

Brignole

Auricchio

Barón-Esquivias

et al. 2014

Revista Española de Cardiología (English Edition)

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confidence: 99%

Non-significant left main disease; truly non-significant?

Wall

Schuijf

Jukema

et al. 2009

Int J Cardiovasc Imaging

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Amongst the advanced cardiac imaging modalities, multislice computed tomography (MSCT) coronary angiography is emerging as a reliable non-invasive method for the assessment of coronary artery disease (CAD), coronary anatomy and cardiac function [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Improvements in computed tomography technology hold the promise of replacing the standard invasive procedure of conventional coronary angiography in selected patient groups. Multiple studies involving over several thousands of patients have established that MSCT angiography is highly accurate for delineation of the presence and severity of coronary atherosclerosis [18][19][20][21][22][23]. The technique provides independent prognostic information over baseline clinical risk factors in patients with known and suspected CAD [24]. MSCT may also reveal the total plaque burden, i.e., both calcified and non-calcified components, for individual patients with coronary atherosclerosis [25][26][27][28][29][30][31][32]. This holds in particular for detecting patients with left main disease as this disease is associated with a poor prognosis. Timely detection of atherosclerosis of the left main stem is crucial as it may determine future interventional therapy. The standard of care for left main coronary artery disease is coronary artery bypass surgery (CABG), but technical advances in percutaneous coronary intervention (PCI) and stenting technology have emboldened the interventional cardiology community to test the feasibility of and document the procedural results for stenting the left main coronary artery [33][34][35][36]. MSCT may therefore play an important role for guiding interventional therapy by early detection and establishing the severity and extent of coronary atherosclerosis of the left main coronary artery.Rodriquez-Granillo et al.[34] explored the differences in plaque burden at different segments of the left main bifurcation and its relationship with the bifurcation angle using high-resolution MSCT. A total of 50 patients were evaluated using a 40-row MSCT scanner. The localization, severity and distribution of plaques within the left main bifurcation were determined. Seventeen (34%) patients presented wall irregularities in the left main stem and in the ostial left circumflex coronary artery, whereas the ostial left descending coronary artery was affected in 32 (64%) patients. More than 90% of plaques were located opposite to the flow divider. Of the 18 patients with a normal ostial left anterior descending coronary artery, 13 (72%) had a bifurcation angle \88.5°, whereas the 63% of the patients with any disease of left anterior descending coronary artery had an angle C88.5°(P = 0.018). At the left main bifurcation, atherosclerotic plaques were commonly eccentric and located opposite to the flow divider. A Editorial comment to the article of Gemici et al.

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Comparison of response to cardiac resynchronization therapy in patients with sinus rhythm versus chronic atrial fibrillation

Cited by 181 publications

References 13 publications

Effects of Atrioventricular Nodal Ablation on Permanent Atrial Fibrillation Patients With Cardiac Resynchronization Therapy: A Systematic Review and Meta‐analysis

Effects of Atrioventricular Nodal Ablation on Permanent Atrial Fibrillation Patients With Cardiac Resynchronization Therapy: A Systematic Review and Meta‐analysis

2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy

Non-significant left main disease; truly non-significant?

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