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July 11, 2020Journal of Cardiovascular Electrophysiology

Probability of sinus rhythm conversion and maintenance in cardiac resynchronization therapy patients with atrial fibrillation during 5‐year follow‐up

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Key result

CRT implantation in AF is associated with ~86% five-year sinus rhythm maintenance in paroxysmal cases.

  • n=328

Why the study?

Atrial fibrillation is highly prevalent in heart failure patients undergoing CRT, but whether an atrial lead should be implanted in these patients remains unclear.

Does CRT implantation with an atrial lead improve sinus rhythm conversion and maintenance in patients with heart failure and atrial fibrillation?

Population

328 consecutive patients with a history of AF receiving CRT implantation

Comparison

Patients with paroxysmal vs persistent vs long-standing persistent AF

Design

Retrospective observational cohort study

Follow-up

5 years

Authors

TZTibor ZiegelhoefferSPSimon PechaRRRilind Rahmani

Discussion

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Overview

CRT with atrial lead linked to high SR maintenance in HF-AF; hypothesis-generating, needs RCTs before practice change.

Study Design

Type

Cohort (n=328)

Multicenter

No

Structured PICO

Does CRT implantation with an atrial lead improve sinus rhythm conversion and maintenance in patients with heart failure and atrial fibrillation?

P
Population
328 consecutive patients with a history of atrial fibrillation (132 paroxysmal, 70 persistent, 126 long-standing persistent) receiving cardiac resynchronization therapy (CRT) implantation.
I
Intervention
Cardiac resynchronization therapy (CRT) implantation with an atrial lead.
O
Outcome
Sinus rhythm conversion and maintenance at discharge and 5-year follow-up.surrogate

CRT implantation with an atrial lead is associated with high rates of long-term sinus rhythm maintenance in patients with heart failure and atrial fibrillation, supporting routine atrial lead implantation in this population.

Cite This Study

Ziegelhoeffer et al. (2020) conducted a cohort in Atrial fibrillation in heart failure patients (n=328). Cardiac resynchronization therapy (CRT) implantation with an atrial lead was evaluated on Sinus rhythm conversion and maintenance. CRT implantation in patients with atrial fibrillation achieved 5-year sinus rhythm maintenance rates of 85.7% for paroxysmal, 69.7% for persistent, and 44.1% for long-standing persistent AF.

synapsesocial.com/papers/6a15604879ff98d0de4e8963https://doi.org/10.1111/jce.14668
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Also Consider

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

  1. 1Atrial fibrillation incidence and impact of biventricular pacing on long-term outcome in patients with heart failure treated with cardiac resynchronization therapy2019 · 12 citations
  2. 2Spontaneous Conversion and Maintenance of Sinus Rhythm by Amiodarone in Patients With Heart Failure and Atrial Fibrillation1998 · 513 citations
  3. 3Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure2003 · 519 citations
  4. 4Temporal Relations of Atrial Fibrillation and Congestive Heart Failure and Their Joint Influence on Mortality2003 · 1,986 citations
  5. 52017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary2017 · 710 citations