Key result
CRT non-response was associated with a significantly increased risk of new-onset atrial fibrillation at 3 years compared to CRT response (50.0% vs. 15.0%; OR 5.67).
Why the study?
Does response to cardiac resynchronization therapy prevent new-onset atrial fibrillation in patients with non-ischaemic dilated cardiomyopathy and severe heart failure?
Cohort (n=58)
No
Does response to cardiac resynchronization therapy prevent new-onset atrial fibrillation in patients with non-ischaemic dilated cardiomyopathy and severe heart failure?
In patients with non-ischaemic dilated cardiomyopathy, responding to cardiac resynchronization therapy 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 response may inform AF risk stratification in non-ischaemic cardiomyopathy; leaves open whether optimizing response reduces incidence.
AIM: The aim of this study was to determine whether or not cardiac resynchronization therapy (CRT) has a favourable effect on the incidence of new-onset atrial fibrillation (AF) in a homogeneous population of patients with non-ischaemic idiopathic-dilated cardiomyopathy and severe heart failure. METHODS: We designed a single-centre prospective study and enrolled 58 patients AF naïve when received CRT. After 1 year of follow-up our population was subdivided into responders (72.4%) and non-responders (27.6%), so as to compare the incidence of AF after 1, 2 and 3 years of follow-up in these two groups. RESULTS: Already after 1 year, there was a significant (p < 0.05) difference in new-onset AF in non-responder patients with respect to responders (18.2% vs. 3.3%). These data were confirmed at 2 years (33.3% vs. 12.2%) and 3 years (50.0% vs. 15.0%) follow-up. In particular, 3 years after device implantation non-responders had an increased risk to develop new-onset AF (OR = 5.67). CONCLUSIONS: This is the first study analysing long-term effects of CRT in a homogeneous population of patients with non-ischaemic dilated cardiomyopathy, indicating the favourable role of this non-pharmacological therapy on the prevention of AF.
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D’Ascia et al. (2011) conducted a cohort in non-ischaemic idiopathic-dilated cardiomyopathy and severe heart failure (n=58). CRT non-response vs. CRT response was evaluated on new-onset atrial fibrillation at 3 years (OR 5.67, p=<0.05). CRT non-response was associated with a significantly increased risk of new-onset atrial fibrillation at 3 years compared to CRT response (50.0% vs. 15.0%; OR 5.67).
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