Outcomes of cardiac resynchronization therapy in patients with intermittent atrial fibrillation or atrial flutter in the COMPANION trial

Kalscheur, Matthew M.; Saxon, Leslie A.; Lee, Byron K.; Steinberg, Jonathan S.; Mei, Chaoqun; Buhr, Kevin A.; DeMets, David L.; Bristow, Michael R.; Singh, Steven

doi:10.1016/j.hrthm.2017.03.024

Cited by 29 publications

(33 citation statements)

References 29 publications

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“…This meta-analysis included 31 studies4–16 19 27–43 with 83 571 patients. All studies were available as full text.…”

Section: Resultsmentioning

confidence: 99%

“…The survival of patients with AF who received CRT was compared with patients with AF with indications for CRT who either received an ICD or were medically managed. Seven studies31 32 37–41 with 13 559 patients were included in the meta-analysis of mortality and HF hospitalisation in patients with AF with and without CRT. Four of the studies were post hoc analyses of the classic CRT trials (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure [COMPANION] trial, Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy [MADIT-CRT] trial, Resynchronization–Defibrillation for Ambulatory Heart Failure [RAFT] trial and The Cardiac Resynchronization-Heart Failure [CARE-HF] trial).…”

Section: Resultsmentioning

confidence: 99%

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Outcomes of cardiac resynchronisation therapy in patients with heart failure with atrial fibrillation: a systematic review and meta-analysis of observational studies

et al. 2019

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BackgroundCardiac resynchronisation therapy (CRT) is beneficial in selected patients with heart failure (HF) in normal sinus rhythm (NSR). We sought to evaluate the impact of CRT with or without atrioventricular junction (AVJ) ablation in patients with HF with concomitant atrial fibrillation (AF)Methods and resultsLiterature was searched (inception through 30 August 2017) for observational studies that reported outcomes in patients with HF with CRT and AF that reported all-cause and cardiovascular mortality. Thirty-one studies with 83, 571 patients were included. CRT did not decrease mortality compared with internal cardioverter defibrillator or medical therapy alone in patients with HF and AF with indications for CRT (OR: 0.851, 95% CI 0.616 to 1.176, p=0.328, I2=86.954). CRT-AF patients had significantly higher all-cause and cardiovascular mortality than CRT-NSR patients ([OR: 1.472, 95% CI 1.301 to 1.664, p=0.000] and [OR: 1.857, 95% CI 1.350 to 2.554, p=0.000] respectively). Change in left ventricular ejection fraction was not different between CRT patients with and without AF (p=0.705). AVJ ablation, however, improved all-cause mortality in CRT-AF patients when compared with CRT-AF patients without AVJ ablation (OR: 0.485, 95% CI 0.247 to 0.952, p=0.035). With AVJ ablation, there was no difference in all-cause mortality in CRT-AF patients compared with CRT-NSR patients (OR: 1.245, 95% CI 0.914 to 1.696, p=0.165).ConclusionThe results of our meta-analysis suggest that AF was associated with decreased CRT benefits in patients with HF. CRT, however, benefits patients with AF with AVJ ablation.

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“…This meta-analysis included 31 studies4–16 19 27–43 with 83 571 patients. All studies were available as full text.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Outcomes of cardiac resynchronisation therapy in patients with heart failure with atrial fibrillation: a systematic review and meta-analysis of observational studies

et al. 2019

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“…A subgroup of patients in the RAFT study had AF and did not appear to benefit, which was ascribed to inadequate ventricular capture . Similarly, a recent report from COMPANION also suggested that patients with a prior history of AF did not benefit from CRT, although incident AF did not appear to reduce benefit in CARE‐HF . At least two trials have compared CRT to right ventricular pacing after atrio‐ventricular node ablation.…”

Section: Discussionmentioning

confidence: 99%

CRT Survey II: a European Society of Cardiology survey of cardiac resynchronisation therapy in 11 088 patients—who is doing what to whom and how?

Dickstein

Normand

Auricchio

et al. 2018

European J of Heart Fail

117

124

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“…Since manifestation of AF is often associated with more advanced disease, the question rises if CRT outcome of patients with paroxysmal AF is the same as in those without it. Subanalysis of the COMPANION (Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure) trial 51 suggests that in patients with no known arrhythmia at baseline (n ¼ 887), CRT led to a significant reduction in the end points of death and any hospitalization as compared with those who were treated only pharmacologically. However, in a subgroup of patients with known AF or atrial flutter (n ¼ 293), this was not the case.…”

Section: Resynchronization In Patients With Intermittent Atrialmentioning

confidence: 99%

Nonpharmacological Treatment of Atrial Fibrillation: What Is the Role of Device Therapy?

et al. 2020

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Atrial fibrillation is the most common arrhythmia in the adult population, and its incidence and prevalence are still rising. Cardiac devices are widely used in clinical practice in the management of various rhythm disturbances and heart failure treatment. Many patients who receive a pacemaker, implantable cardioverter-defibrillator, or cardiac resynchronization therapy also experience atrial fibrillation in the course of their life. Therefore, this review aims to describe the role of these devices in the treatment and prevention of atrial fibrillation in the device recipients. In addition, all these implantable devices also serve as permanent ECG (electrocardiogram) monitors, thus providing important information about the presence and characteristics of atrial fibrillation that may or may not be detected by the patient but can modify our therapeutical approach with regard to the stroke prevention.

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Outcomes of cardiac resynchronization therapy in patients with intermittent atrial fibrillation or atrial flutter in the COMPANION trial

Cited by 29 publications

References 29 publications

Outcomes of cardiac resynchronisation therapy in patients with heart failure with atrial fibrillation: a systematic review and meta-analysis of observational studies

Outcomes of cardiac resynchronisation therapy in patients with heart failure with atrial fibrillation: a systematic review and meta-analysis of observational studies

CRT Survey II: a European Society of Cardiology survey of cardiac resynchronisation therapy in 11 088 patients—who is doing what to whom and how?

Nonpharmacological Treatment of Atrial Fibrillation: What Is the Role of Device Therapy?

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