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Cardiac resynchronization therapy in patients with permanent atrial fibrillation. Is it mandatory to ablate the atrioventricular junction to obtain a good response?
- Source :
- European journal of heart failure. 14(6)
- Publication Year :
- 2012
-
Abstract
- Aim Current guidelines recommend atrioventricular junction (AVJ) ablation in patients with atrial fibrillation (AF) treated with cardiac resynchronization therapy (CRT). Our study compared the CRT response of patients in sinus rhythm (SR) vs. AF. Methods and results In this observational, prospective, multicentre study, patients were grouped by intrinsic rhythm. For the first 2 months, the negative chronotropic drug was optimized in the AF group. If ventricular pacing was ≤85%, AVJ ablation was recommended. Responders were defined as patients who survived without requiring heart transplant and had a ≥ 10% reduction in left ventricular end-systolic volume (LVESV) at 12 months after implantation. Of 202 patients included, 156 (77%) were in SR and 46 (23%) had AF. After drug optimization, only 13/46 (28%) of the AF patients required AVJ ablation (AF + AVJ). The percentage of responders was 83/156 (53%) for SR vs. 22/46 (48%) AF (P = 0.4). Among AF patients the response was 16/33 (48%) for AF with non-AVJ ablation vs. 6/13 (46%) AF + AVJ, P = 0.56. The LVESV decreased in all three groups: −30 ± 39 mL, −24 ± 43 mL, and −22 ± 36 mL, respectively (P = 0.75). Mortality was higher in patients with AF compared with SR: 10/46 (21%) vs. 9/156 (5.7%), log rank 10.6, P
- Subjects :
- Chronotropic
Male
medicine.medical_specialty
medicine.medical_treatment
Statistics as Topic
Cardiac resynchronization therapy
Kaplan-Meier Estimate
Cardiac Resynchronization Therapy
Risk Factors
Internal medicine
Atrial Fibrillation
Confidence Intervals
Medicine
Humans
Sinus rhythm
Aged
Ultrasonography
Analysis of Variance
business.industry
Atrial fibrillation
medicine.disease
Ablation
Confidence interval
Log-rank test
Spain
Heart failure
Cardiology
Atrioventricular Node
Catheter Ablation
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 18790844
- Volume :
- 14
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- European journal of heart failure
- Accession number :
- edsair.doi.dedup.....86cf63150ca63ac226e7bddb6c8b6071