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July 7, 2020Open Access

Cardiac resynchronization therapy with an atrial lead in patients with longstanding-persistent AF was associated with stable ejection fraction and lower mitral regurgitation rates at 1 year.

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Why the study?

Data on CRT benefits in patients with both HF and AF remain limited, as patients with atrial arrhythmias were excluded from major trials.

Does CRT placement with an atrial lead improve cardiac parameters and sinus rhythm maintenance in patients with heart failure and atrial fibrillation?

Population

328 patients with AF who received CRT for HF at a single center

Comparison

CRT with an atrial lead vs without atrial lead placement

Design

Single-center retrospective analysis

Follow-up

5-year follow-up

Key result

Cardiac resynchronization therapy with an atrial lead in patients with longstanding-persistent AF was associated with stable ejection fraction and lower mitral regurgitation rates at 1 year.

Authors

MRMohammad RamadanMRMarwan M. Refaat

Discussion

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Member takes

Overview

May support atrial lead use in CRT for AF; leaves open prospective confirmation of remodeling benefits.

Study Design

Type

Observational (n=328)

Multicenter

No

Structured PICO

Does CRT placement with an atrial lead improve cardiac parameters and sinus rhythm maintenance in patients with heart failure and atrial fibrillation?

P
Population
328 patients with heart failure (HF) and atrial fibrillation (AF) (paroxysmal, persistent, and longstanding-persistent) who received cardiac resynchronization therapy (CRT)
I
Intervention
Cardiac resynchronization therapy (CRT) placement with an additional atrial lead
C
Comparator
Cardiac resynchronization therapy (CRT) placement without an atrial lead
O
Outcome
Rhythm course (sinus rhythm conversion and maintenance) and cardiac parameters (NYHA class, mitral regurgitation, LVEF, left atrial diameter, LVESD, LVEDD) at 1 and 5 yearssurrogate

CRT with an atrial lead may be associated with improved myocardial function and reverse remodeling in patients with HF and AF, though larger prospective studies are needed to confirm statistical significance.

Limitations

  • Single center study
  • Relatively small sample size
  • Results were reported as percentages with no level of statistical significance specified
  • Results reported as percentages with no level of significance specified
  • Single center

Cite This Study

Ramadan et al. (2020) conducted an observational in Heart failure and atrial fibrillation (n=328). Cardiac resynchronization therapy (CRT) with an atrial lead vs. CRT without atrial lead placement was evaluated on Sinus rhythm conversion and maintenance, and cardiac parameters (NYHA class, MR, LVEF, left atrial diameter). Cardiac resynchronization therapy with an atrial lead in patients with longstanding-persistent AF was associated with stable ejection fraction and lower mitral regurgitation rates at 1 year.

synapsesocial.com/papers/6a1aad2fa020f538e6857ecfhttps://doi.org/10.22541/au.159415512.24862269
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Also Consider

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

  1. 1Cardiac resynchronization therapy in heart failure patients with atrial fibrillation2013
  2. 2Cardiac Resynchronization Therapy in Patients with Atrial Fibrillation: A 2‐Year Follow‐Up Study2013 · 8 citations
  3. 3Atrial tachyarrhythmias and cardiac resynchronisation therapy: clinical and therapeutic implications2010 · 16 citations
  4. 4The Influence of Atrial Fibrillation on Cardiac Resynchronization Therapy2014 · 3 citations
  5. 5Does permanent atrial fibrillation modify response to cardiac resynchronization therapy in heart failure patients?2017 · 4 citations