Cardiac resynchronization therapy in heart failure patients with atrial fibrillation requires specific management strategies to address AF burden and ensure adequate device delivery.
Does Cardiac resynchronization therapy improve outcomes in heart failure patients with atrial fibrillation?
This review provides an overview of the management and effects of cardiac resynchronization therapy in heart failure patients with concurrent atrial fibrillation.
Cardiac resynchronization therapy (CRT) is an important device-based, non-pharmacological approach that has shown, in large randomized trials, to improve left ventricular (LV) function and reduce both morbidity and mortality rates in selected patients affected by advanced heart failure (HF): New York Heart Association (NYHA) functional class III-IV, reduced LV systolic function with an ejection fraction (EF) or=120 ms, on optimal medical therapy, and who were in sinus rhythm. For the first time, the latest ESC and AHA/ACC/HRS Guidelines have considered atrial fibrillation (AF) patients, who constitute an important subgroup of HF patients, as eligible to receive CRT. Nevertheless, these Guidelines did not include a strategy for defining differentiated approaches according to AF duration or burden. In this review, the authors explain in which way AF may interfere with adequate CRT delivery, how to manage different AF burden, and finally present a brief overview on the effects of CRT in AF patients.
Gasparini et al. (Tue,) conducted a review in Heart failure with atrial fibrillation. Cardiac resynchronization therapy (CRT) was evaluated. Cardiac resynchronization therapy in heart failure patients with atrial fibrillation requires specific management strategies to address AF burden and ensure adequate device delivery.