Key result
Permanent AF shows no mortality difference versus sinus rhythm in HF patients receiving CRT-D.
Why the study?
Data on the benefit of CRT in HF patients with permanent AF have been conflicting.
Does permanent atrial fibrillation affect mortality and appropriate shocks in heart failure patients receiving CRT defibrillators compared to sinus rhythm?
Population
1141 patients with CRT defibrillators (229 with permanent AF, 912 in sinus rhythm)
Comparison
Permanent AF vs sinus rhythm at device implantation
Design
Retrospective propensity score inverse-probability weighted cohort study
Follow-up
Median 24 months
Authors
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Permanent AF was not associated with higher mortality in CRT-D recipients; hypothesis-generating for CRT optimization and shock risk.
Cohort (n=1,141)
Does permanent atrial fibrillation affect mortality and appropriate shocks in heart failure patients receiving CRT defibrillators compared to sinus rhythm?
Effect estimate: HR 1.32 (95% CI 0.82-2.15)
p-value: p=0.25
In patients with CRT defibrillators, permanent AF is not associated with increased mortality compared to sinus rhythm, but AF patients with suboptimal CRT (<98%) have a significantly higher risk of appropriate shocks.
Rapacciuolo et al. (2021) conducted a cohort in Heart failure (n=1,141). Permanent atrial fibrillation vs. Sinus rhythm was evaluated on Total mortality (HR 1.32, 95% CI 0.82-2.15, p=0.25). In heart failure patients receiving CRT defibrillators, total mortality did not differ between those with permanent atrial fibrillation and sinus rhythm (HR 1.32; 95% CI 0.82-2.15; P=0.25).
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