Key result
At 3-year follow-up, patients who did not respond to cardiac resynchronization therapy had a significantly increased risk of developing new-onset atrial fibrillation compared to responders (50.0% vs 15.0%, OR 5.67).
Why the study?
Does a favorable response to cardiac resynchronization therapy prevent new-onset atrial fibrillation in patients with non-ischemic dilated cardiomyopathy and severe heart failure?
Cohort (n=58)
No
Does a favorable response to cardiac resynchronization therapy prevent new-onset atrial fibrillation in patients with non-ischemic dilated cardiomyopathy and severe heart failure?
In patients with non-ischemic dilated cardiomyopathy, a favorable clinical and echocardiographic response to CRT is associated with a significantly lower risk of developing new-onset atrial fibrillation over 3 years.
Answers are grounded in this paper and cite their sources.
CRT nonresponse marks higher new-onset AF risk; hypothesis-generating for whether response prevents AF, needing randomized confirmation.
Albeit several studies examined the association between cardiac resynchronization therapy (CRT) and atrial fibrillation (AF) in heart failure (HF), results are still unclear and quite conflicting. We thereby designed a single-center prospective study to determine whether CRT has a favorable effect on the incidence of new-onset AF in a homogeneous population of patients with non-ischemic idiopathic dilated cardiomyopathy and severe heart failure HF. We enrolled 58 patients, AF naïve when received CRT. After 1 year of follow-up our population was subdivided into responders (72.4%) and non (27.6%), so to compare the incidence of AF after 1, 2 and 3 years of follow-up in these two groups. Already after 1 year, there is a significant (p<0.05) difference in new-onset AF in non-responder patients respect to responders (18.2% vs 3.3%). These data are confirmed at 2 year (33.3% vs 12.2%) and 3 year (50.0% vs 15.0%) follow-up. In particular, at 3 year follow-up, non-responders have an increased risk to develop new-onset AF (OR=5.67, 95% confidence interval = 1.36-23.59, p=0.019). The present work suggests a possible favorable role of this non-pharmacological therapy, on the prevention of AF.
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Santulli et al. (2012) conducted a cohort in Non-ischemic idiopathic dilated cardiomyopathy and severe heart failure (n=58). Cardiac resynchronization therapy (CRT) non-response vs. CRT response was evaluated on Incidence of new-onset atrial fibrillation at 3 years (OR 5.67, 95% CI 1.36-23.59, p=0.019). At 3-year follow-up, patients who did not respond to cardiac resynchronization therapy had a significantly increased risk of developing new-onset atrial fibrillation compared to responders (50.0% vs 15.0%, OR 5.67).
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