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December 15, 2023MedicinaOpen Access

CRT is linked to a ~5% increase in AF frequency, predicted strongly by CRT non-response.

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Why the study?

It was unknown whether CRT with biventricular pacing reduces the risk of AF development, and predictors of AF occurrence needed identification.

Does cardiac resynchronization therapy with biventricular pacing reduce the risk of atrial fibrillation in patients with systolic heart failure?

Population

126 patients with symptomatic systolic HF eligible for CRT with biventricular pacing

Comparison

Clinical responders vs non-responders to CRT

Design

Prospective study

Follow-up

24 months

Key result

Cardiac resynchronization therapy was associated with an increase in atrial fibrillation frequency from 52.4% to 56.9% at 2 years (p<0.001), with non-response to CRT as a strong predictor.

Authors

AGAleksandra GrbovićSPS. PavlovićVŽVasko Žugić

Discussion

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Overview

AF frequency rose after CRT in this cohort; leaves open whether biventricular pacing affects arrhythmia risk in systolic HF.

Study Design

Type

Cohort (n=126)

Structured PICO

Does cardiac resynchronization therapy with biventricular pacing reduce the risk of atrial fibrillation in patients with systolic heart failure?

P
Population
126 patients with systolic heart failure, mean age 63.8 ± 9.1 years. Inclusion criteria: LVEF ≤ 35%, QRS duration ≥ 130 msec, and persistent HF symptoms of NYHA II or III despite optimal drug therapy.
I
Intervention
Cardiac resynchronization therapy (CRT) with biventricular pacing
O
Outcome
Occurrence of atrial fibrillation (AF) and identification of its predictors at 24 months post-implantationhard clinical

Main Result

Absolute Event Rate: 56.9% vs 52.4%

p-value: p=<0.001

In patients with systolic heart failure receiving CRT, the frequency of AF increased over 24 months, with non-response to CRT, larger LA diameter, and posterolateral CS lead position identified as significant predictors of AF occurrence.

Cite This Study

Grbović et al. (2023) conducted a cohort in Systolic heart failure (n=126). Cardiac resynchronization therapy (CRT) with biventricular pacing vs. Baseline was evaluated on Frequency of atrial fibrillation (AF) occurrence (p=<0.001). Cardiac resynchronization therapy was associated with an increase in atrial fibrillation frequency from 52.4% to 56.9% at 2 years (p<0.001), with non-response to CRT as a strong predictor.

synapsesocial.com/papers/6a1628d79e37e13c01c4fffchttps://doi.org/10.3390/medicina59122178
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Also Consider

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

  1. 1Predictors of rhythm outcomes after cardiac resynchronization therapy in atrial fibrillation patients: When should we use an atrial lead?2020 · 1 citations
  2. 2Does permanent atrial fibrillation modify response to cardiac resynchronization therapy in heart failure patients?2017 · 4 citations
  3. 3Cardiac Resynchronization Therapy in Patients with Atrial Fibrillation2020 · 1 citations
  4. 4Predictors for Cardiac Resynchronization Therapy Response2014 · 12 citations
  5. 5Impact of atrial fibrillation and biventricular pacing percentage on long-term outcome in patients with heart failure treated with cardiac resynchronization therapy2021 · 1 citations