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January 11, 2019PLoS ONEOpen Access

Over a median follow-up of 1.6 years, there were no significant differences in long-term composite clinical events between the AF-SVR and SR groups (35% vs 24%; HR 1.71, 95% CI 0.23-12.48, P=0.60).

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Why the study?

It remains unclear whether CRT is as effective in patients with AF accompanied by slow ventricular response as in those with SR.

Does cardiac resynchronization therapy provide comparable echocardiographic reverse remodeling and long-term clinical outcomes in patients with atrial fibrillation and slow ventricular response compared to those with sinus rhythm?

Population

17 AF-SVR patients and 88 SR patients receiving CRT

Comparison

AF-SVR vs SR after CRT treatment

Design

Comparative cohort study

Follow-up

Median 1.6 (interquartile range: 0.8-2.2) years

Authors

JHJin Kyung HwangHGHye Bin GwagKPKyoung‐Min Park

Discussion

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Member takes

Overview

Inconclusive for CRT equivalence in AF-SVR versus SR due to wide CI; larger prospective studies needed.

Structured PICO

Does cardiac resynchronization therapy provide comparable echocardiographic reverse remodeling and long-term clinical outcomes in patients with atrial fibrillation and slow ventricular response compared to those with sinus rhythm?

P
Population
105 patients receiving cardiac resynchronization therapy, including 17 with atrial fibrillation accompanied by slow ventricular response (AF-SVR, < 60 beats/min) and 88 with sinus rhythm (SR).
I
Intervention
Cardiac resynchronization therapy (CRT) in patients with atrial fibrillation and slow ventricular response (AF-SVR)
C
Comparator
Cardiac resynchronization therapy (CRT) in patients with sinus rhythm (SR)
O
Outcome
Echocardiographic reverse remodeling at 6 and 12 months, and long-term composite clinical outcomes (cardiac death, heart transplantation, and heart failure-related hospitalization)composite

Cardiac resynchronization therapy provides comparable beneficial effects in terms of reverse remodeling and clinical outcomes for patients with atrial fibrillation and slow ventricular response compared to those with sinus rhythm.

Cite This Study

Hwang et al. (2019) studied this question.

synapsesocial.com/papers/6a101e214fb650da4ffef86chttps://doi.org/10.1371/journal.pone.0210603
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation2008 · 123 citations
  2. 2Cardiac resynchronisation therapy in chronic atrial fibrillation: impact on left atrial size and reversal to sinus rhythm2005 · 71 citations
  3. 3Does permanent atrial fibrillation modify response to cardiac resynchronization therapy in heart failure patients?2017 · 4 citations
  4. 4Long-term outcomes of cardiac resynchronization therapy are worse in patients who require atrioventricular junction ablation for atrial fibrillation than in those with sinus rhythm2013 · 15 citations
  5. 5Management of atrial fibrillation in cardiac resynchronization therapyClinical practice of CRT: how to improve the success rate2004 · 8 citations