Resumption of sinus rhythm in patients with heart failure and permanent atrial fibrillation undergoing cardiac resynchronization therapy: a longitudinal observational study

Gasparini, Maurizio; Steinberg, Jonathan S.; Arshad, Aysha; Regoli, François; Galimberti, Paola; Rosier, Arnaud; Daubert, Jean Claude; Klersy, Catherine; Kamath, Ganesh S; Leclercq, Christophe

doi:10.1093/eurheartj/ehp572

Cited by 72 publications

(35 citation statements)

References 21 publications

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“…Last but not least, AVJ ablation is the most powerful predictor of sinus rhythm resumption in permanent atrial fibrillation patients treated with CRT [13]. The conversion from atrial fibrillation to sinus rhythm even after many years of CRT seems to be related to the higher biventricular pacing (BVP) observed in ablated patients, and consequent volume and 'electric' reverse remodeling.…”

Section: Key Pointsmentioning

confidence: 99%

The importance of increased percentage of biventricular pacing to improve clinical outcomes in patients receiving cardiac resynchronization therapy

Gasparini

Galimberti

Ceriotti

2013

Current Opinion in Cardiology

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Section: Key Pointsmentioning

confidence: 99%

The importance of increased percentage of biventricular pacing to improve clinical outcomes in patients receiving cardiac resynchronization therapy

Gasparini

Galimberti

Ceriotti

2013

Current Opinion in Cardiology

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“…150 msec, a left atrial diameter of ! 50 mm and AV junction ablation (6). Although this patient had only one of these predictors, CRT successfully restored the sinus rhythm in combination with oral amiodarone therapy initiated one month after device implantation.…”

Section: Discussionmentioning

confidence: 83%

Heart Failure Exacerbation Associated with Newly Developed Atrioventricular Dyssynchrony after Chemical Conversion to a Sinus Rhythm in a Patient Receiving Cardiac Resynchronization Therapy

et al. 2013

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A 58-year-old woman with chronic heart failure (CHF) received cardiac resynchronization-defibrillator (CRT-D) therapy without atrial lead implantation due to longstanding atrial fibrillation (AF). Three months after oral amiodarone therapy was initiated for the treatment of non-sustained ventricular tachycardia detected by the CRT-D device, the patient's heart failure symptoms worsened and 12-lead electrocardiography showed newly emerged p-waves with atrioventricular (AV) dissociation. Immediately after the device was upgraded to the DDD-biventricular pacemaker, the patient's heart failure symptoms and cardiac function dramatically improved, which suggests that AV dissociation has a much more negative impact on the cardiac function than AF in patients with CHF.

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“…24 These studies suggest that atrial fibrillation burden declines in the first 3 to 6 months after CRT-D implantation 25,26 and resolves altogether in some patients. 27 Patients may also experience better outcomes with a high degree of biventricular pacing or atrioventricular junction ablation. 28–30 A meta-analysis of 23 observational studies found that atrial fibrillation was associated with a higher risk of nonresponse and all-cause mortality, but only a quarter of the patients had atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Cardiac Resynchronization Therapy Among Patients With Heart Failure and Atrial Fibrillation

Khazanie

Greiner

Al‐Khatib

et al. 2016

Circ: Heart Failure

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Background Atrial fibrillation is common in patients with heart failure, but outcomes of patients with both conditions who receive cardiac resynchronization therapy with defibrillator (CRT-D) compared with an implantable cardioverter-defibrillator (ICD) alone are unclear. Methods and Results Using the National Cardiovascular Data Registry’s ICD Registry™ linked with Medicare claims, we identified 8951 patients with atrial fibrillation who were eligible for CRT-D and underwent first-time device implantation for primary prevention between April 2006 and December 2009. We used Cox proportional hazards models and inverse probability-weighted estimates to compare outcomes with CRT-D vs ICD alone. Cumulative incidence of mortality (744 [33%] for ICD; 1893 [32%] for CRT-D) and readmission (1788 [76%] for ICD; 4611 [76%] for CRT-D) within 3 years and complications within 90 days were similar between groups. After inverse weighting for the probability of receiving CRT-D, risks of mortality (hazard ratio [HR], 0.83; 95% CI, 0.75–0.92), all-cause readmission (HR, 0.86; 95% CI, 0.80–0.92), and heart failure readmission (HR, 0.68, 95% CI, 0.62–0.76) were lower with CRT-D compared with ICD alone. There was no significant difference in the 90-day complication rate (HR, 0.88; 95% CI, 0.60–1.29). We observed hospital-level variation in the use of CRT-D among patients with atrial fibrillation. Conclusions Among eligible patients with heart failure and atrial fibrillation, CRT-D was associated with lower risks of mortality, all-cause readmission, and heart failure readmission and with a similar risk of complications compared with ICD alone.

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Resumption of sinus rhythm in patients with heart failure and permanent atrial fibrillation undergoing cardiac resynchronization therapy: a longitudinal observational study

Abstract: One in every 10 HF patients with permanent AF may experience SRR after CRT. Baseline EDD

Cited by 72 publications

References 21 publications

The importance of increased percentage of biventricular pacing to improve clinical outcomes in patients receiving cardiac resynchronization therapy

The importance of increased percentage of biventricular pacing to improve clinical outcomes in patients receiving cardiac resynchronization therapy

Heart Failure Exacerbation Associated with Newly Developed Atrioventricular Dyssynchrony after Chemical Conversion to a Sinus Rhythm in a Patient Receiving Cardiac Resynchronization Therapy

Comparative Effectiveness of Cardiac Resynchronization Therapy Among Patients With Heart Failure and Atrial Fibrillation

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