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October 1, 2021European Heart Journal

Impact of atrial fibrillation and biventricular pacing percentage on long-term outcome in patients with heart failure treated with cardiac resynchronization therapy

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Key result

Pre-procedural atrial fibrillation was associated with a higher risk of heart failure hospitalization or death compared to sinus rhythm (73.8% vs 42.6%; HR 8.949, 95% CI 2.429-32.972, p=0.001).

Why the study?

Does pre-procedural atrial fibrillation worsen outcomes (hospitalization due to HF or death) in heart failure patients treated with cardiac resynchronization therapy?

Population

118 heart failure patients undergoing cardiac resynchronization therapy implantation, mean age 69±11 years…

Comparison

Pre-procedural atrial fibrillation (AF) vs Sinus rhythm (SR)

Design

Cohort

Follow-up

mean 43±18 months

Authors

MPMarta PereiraPLPedro LeiteGDGuilherme Mascarenhas Dias

Discussion

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Overview

May warrant intensified monitoring in CRT recipients with pre-procedural AF; leaves open whether rhythm control alters outcomes.

Study Design

Type

Cohort (n=118)

Structured PICO

Does pre-procedural atrial fibrillation worsen outcomes (hospitalization due to HF or death) in heart failure patients treated with cardiac resynchronization therapy?

P
Population
118 heart failure patients (mean age 69 years, 33.9% female) undergoing CRT implantation, followed for a mean of 43 months.
E
Exposure
Pre-procedural atrial fibrillation (AF)
C
Comparator
Sinus rhythm (SR)
O
Outcome
Composite endpoint of hospitalization due to HF or death for any causecomposite

Main Result

Hazard Ratio: 8.949 (95% CI 2.429–32.972)

Absolute Event Rate: 73.8% vs 42.6%

p-value: p=0.001

Pre-procedural atrial fibrillation and lower biventricular pacing percentages are strong independent predictors of increased mortality and heart failure hospitalization in patients receiving cardiac resynchronization therapy.

Cite This Study

Pereira et al. (2021) conducted a cohort in Heart failure treated with cardiac resynchronization therapy (CRT) (n=118). Pre-procedural atrial fibrillation vs. Sinus rhythm was evaluated on Composite endpoint of hospitalization due to HF or death for any cause (HR 8.949, 95% CI 2.429-32.972, p=0.001). Pre-procedural atrial fibrillation was associated with a higher risk of heart failure hospitalization or death compared to sinus rhythm (73.8% vs 42.6%; HR 8.949, 95% CI 2.429-32.972, p=0.001).

synapsesocial.com/papers/6ab32983f522bae22b32a4a6https://doi.org/10.1093/eurheartj/ehab724.0706
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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. 2Predictors of Higher Frequency of Atrial Fibrillation in Patients with Cardiac Resynchronization Therapy2023
  3. 3Clinical Implications of Device-Detected Atrial Fibrillation in Cardiac Resynchronization Therapy2023 · 4 citations
  4. 4The Epidemic of Inadequate Biventricular Pacing in Patients With Persistent or Permanent Atrial Fibrillation and Its Association With Mortality2014 · 82 citations
  5. 5Does permanent atrial fibrillation modify response to cardiac resynchronization therapy in heart failure patients?2017 · 4 citations