|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2006; 48:734-743, doi:10.1016/j.jacc.2006.03.056
(Published online 24 July 2006). © 2006 by the American College of Cardiology Foundation |
,
* Department of Cardiology IRCCS Istituto Clinico Humanitas Rozzano-Milano, Milan, Italy
Service of Biometry & Clinical Epidemiology, IRCCS Policlinico San Matteo, Pavia, Italy
Division of Cardiology, University Hospital, Magdeburg, Germany
Department of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
Manuscript received November 11, 2005; revised manuscript received February 10, 2006, accepted March 16, 2006.
* Reprint requests and correspondence: Dr. Maurizio Gasparini, IRCCS Istituto Clinico Humanitas, Rozzano-Milano, Italy, Via Manzoni 56, Rozzano, Milano, Italy. (Email: maurizio.gasparini{at}humanitas.it).
OBJECTIVES: The goal of this study was to investigate the effects of cardiac resynchronization therapy (CRT) in heart failure patients with permanent atrial fibrillation (AF) and the role of atrioventricular junction (AVJ) ablation.
BACKGROUND: Cardiac resynchronization therapy has been proven effective in heart failure patients with sinus rhythm (SR). However, little is known about the effects of CRT in heart failure patients with permanent AF.
METHODS: Efficacy of CRT on ventricular function, exercise performance, and reversal of maladaptive remodeling process was prospectively compared in 48 patients with permanent AF in whom ventricular rate was controlled by drugs, thus resulting in apparently adequate delivery of biventricular pacing (>85% of pacing time), and in 114 permanent AF patients, who had undergone AVJ ablation (100% of resynchronization therapy delivery). The clinical and echocardiographic long-term outcomes of both groups were compared with those of 511 SR patients treated with CRT.
RESULTS: Both SR and AF groups showed significant and sustained improvements of all assessed parameters (model p < 0.001 for all parameters). However, within the AF group, only patients who underwent ablation showed a significant increase of ejection fraction (p < 0.001), reverse remodeling effect (p < 0.001), and improved exercise tolerance (p < 0.001); no improvements were observed in AF patients who did not undergo ablation.
CONCLUSIONS: Heart failure patients with ventricular conduction disturbance and permanent AF treated with CRT showed large and sustained long-term (up to 4 year) improvements of left ventricular function and functional capacity, similar to patients in SR, only if AVJ ablation was performed.
| |||||||||||
This article has been cited by other articles:
|
|
 |
|
  R Gradaus, V Stuckenborg, A Loher, J Kobe, F Reinke, S Gunia, C Vahlhaus, G Breithardt, and C Bruch Diastolic filling pattern and left ventricular diameter predict response and prognosis after cardiac resynchronisation therapy Heart, August 1, 2008; 94(8): 1026 - 1031. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W H Fung, G. W K Yip, and C.-M. Yu Does atrial fibrillation preclude biventricular pacing? Heart, July 1, 2008; 94(7): 826 - 827. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Gasparini, A. Auricchio, M. Metra, F. Regoli, C. Fantoni, B. Lamp, A. Curnis, J. Vogt, C. Klersy, and for the Multicentre Longitudinal Observational Stu Long-term survival in patients undergoing cardiac resynchronization therapy: the importance of performing atrio-ventricular junction ablation in patients with permanent atrial fibrillation Eur. Heart J., July 1, 2008; 29(13): 1644 - 1652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Leclercq and P. Mabo Cardiac resynchronization therapy and atrial fibrillation. Do we have a final answer? Eur. Heart J., July 1, 2008; 29(13): 1597 - 1599. [Full Text] [PDF]
|
|
|
|
|
|
K Khadjooi, P W Foley, S Chalil, J Anthony, R E A Smith, M P Frenneaux, and F Leyva Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation Heart, July 1, 2008; 94(7): 879 - 883. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Ferreira, P. Adragao, D. M. Cavaco, R. Candeias, F. B. Morgado, K. R. Santos, E. Santos, and J. A. Silva Benefit of cardiac resynchronization therapy in atrial fibrillation patients vs. patients in sinus rhythm: the role of atrioventricular junction ablation Europace, July 1, 2008; 10(7): 809 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Szili-Torok, A. Mihalcz, and L. Jordaens The 'Happy Ending Problem' of cardiac pacing? Cardiac resynchronization therapy for patients with atrial fibrillation and heart failure after atrioventricular junction ablation Europace, July 1, 2008; 10(7): 779 - 781. [Full Text] [PDF]
|
|
|
|
|
|
M. Gasparini Long-term survival in patients undergoing cardiac resynchronization therapy: the importance of atrio-ventricular junction ablation in patients with permanent atrial fibrillation: reply Eur. Heart J., June 27, 2008; (2008) ehn291v1. [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, D. L. Hayes, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons J. Am. Coll. Cardiol., May 27, 2008; 51(21): e1 - e62. [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, D. L. Hayes, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons Circulation, May 27, 2008; 117(21): e350 - e408. [Full Text] [PDF]
|
|
|
|
|
|
S. Buck, M. Rienstra, A. H. Maass, W. Nieuwland, D. J. Van Veldhuisen, and I. C. Van Gelder Cardiac resynchronization therapy in patients with heart failure and atrial fibrillation: importance of new-onset atrial fibrillation and total atrial conduction time Europace, May 1, 2008; 10(5): 558 - 565. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Leclercq, F. Gadler, W. Kranig, S. Ellery, D. Gras, A. Lazarus, J. Clementy, E. Boulogne, J.-C. Daubert, and for the TRIP-HF (Triple Resynchronization In Paced A Randomized Comparison of Triple-Site Versus Dual-Site Ventricular Stimulation in Patients With Congestive Heart Failure J. Am. Coll. Cardiol., April 15, 2008; 51(15): 1455 - 1462. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Auricchio and F. W. Prinzen Cardiac Resynchronization Therapy: The More Pacing Sites, the Better the Outcome? J. Am. Coll. Cardiol., April 15, 2008; 51(15): 1463 - 1465. [Full Text] [PDF]
|
|
|
|
|
|
S S. Barold and B. Herwerg Pacing in heart failure: how many leads and where? Heart, January 1, 2008; 94(1): 10 - 12. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Leclercq, G. B. Bleeker, C. Linde, E. Donal, J. J. Bax, M. J. Schalij, and C. Daubert Cardiac resynchronization therapy: clinical results and evolution of candidate selection Eur. Heart J. Suppl., December 1, 2007; 9(suppl_I): I94 - I106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Nieuwlaat, L. W. Eurlings, A. Capucci, and H. J.G.M. Crijns Atrial fibrillation in the 'real world': undecided issues Eur. Heart J. Suppl., December 1, 2007; 9(suppl_I): I122 - I128. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-R. Neuberger, C. Mewis, D. J. van Veldhuisen, U. Schotten, I. C. van Gelder, M. A. Allessie, and M. Bohm Management of atrial fibrillation in patients with heart failure Eur. Heart J., November 1, 2007; 28(21): 2568 - 2577. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Europace, October 1, 2007; 9(10): 959 - 998. [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Eur. Heart J., September 2, 2007; 28(18): 2256 - 2295. [Full Text] [PDF]
|
|
|
|
|
|
A. Achilli, F. Turreni, M. Gasparini, M. Lunati, M. Sassara, M. Santini, M. Landolina, L. Padeletti, A. Puglisi, M. Bocchiardo, et al. Efficacy of cardiac resynchronization therapy in very old patients: the Insync/Insync ICD Italian Registry Europace, September 1, 2007; 9(9): 732 - 738. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Hohnloser and E. N. Prystowsky CRT-D use in heart failure: too little or too much? Eur. Heart J. Suppl., September 1, 2007; 9(suppl_G): G9 - G16. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Gammage External cardioversion in patients with implanted cardiac devices: is there a problem? Eur. Heart J., July 2, 2007; 28(14): 1668 - 1669. [Full Text] [PDF]
|
|
|
|
|
|
M. M. Scheinman and E. Keung The Year in Clinical Cardiac Electrophysiology J. Am. Coll. Cardiol., May 22, 2007; 49(20): 2061 - 2069. [Full Text] [PDF]
|
|
|
|
|
|
J. S. Steinberg Desperately Seeking a Randomized Clinical Trial of Resynchronization Therapy for Patients With Heart Failure and Atrial Fibrillation J. Am. Coll. Cardiol., August 15, 2006; 48(4): 744 - 746. [Full Text] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
