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Four-Year Efficacy of Cardiac Resynchronization Therapy on Exercise Tolerance and Disease Progression

The Importance of Performing Atrioventricular Junction Ablation in Patients With Atrial Fibrillation

Maurizio Gasparini, MD^_*,_*, Angelo Auricchio, MD, PhD^,, François Regoli, MD^_*, Cecilia Fantoni, MD, Mihoko Kawabata, MD, Paola Galimberti, MD^_*, Daniela Pini, MD^_*, Carlo Ceriotti, MD^_*, Edoardo Gronda, MD^_*, Catherine Klersy, MD, MSc, Simona Fratini, MD and Helmut H. Klein, MD

^_* 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

View larger version (24K): [in a new window]   Figure 1 This figure presents sequential changes of left ventricular ejection fraction (A), exercise capacity (functional capacity score) (B), and changes in left ventricular end-systolic volume (C) in patients with sinus rhythm (SR) and atrial fibrillation (AF) with and without atrioventricular junction (AVJ) ablation. Significance values within the single groups are given in Tables 2 and 4. Also included (D) below the legend are the total number of patients reaching the different follow-up visits and the number of deaths that occurred in the time interval since last follow-up.

View larger version (20K): [in a new window]   Figure 2 Percentage of responders to cardiac resynchronization therapy (CRT) at different follow-up times are presented. The open bars refer to sinus rhythm patients, the ruled bars relate to atrial fibrillation with atrioventricular junction ablation, and, finally, the solid bars refer to atrial fibrillation without atrioventricular junction ablation. There was a significantly higher proportion of responders in patients with sinus rhythm or atrial fibrillation with atrioventricular junction ablation compared with atrial fibrillation patients without atrioventricular junction ablation.