Development of Heart Failure From Transient Atrial Fibrillation Attacks in Responders to Cardiac Resynchronization Therapy

JACC. Clinical Electrophysiology
Ikutaro NakajimaKengo F Kusano

Abstract

This study aimed to clarify the clinical impact of transient atrial fibrillation (AF) attacks themselves and the efficacy of cardiac resynchronization therapy (CRT) in patients with intermittent AF. The benefit of CRT in patients with intermittent AF, especially the effect of the AF attacks themselves, remains unclear. Among our cohort of 269 consecutive CRT patients, we compared the percent of biventricular pacing (BIVP%) and other clinical characteristics between patients with intermittent AF and those with sinus rhythm (SR). During a median follow-up of 942 days (interquartile range: 379 to 1,464 days) a total of 22 patients, including 59% of CRT responders, developed heart failure (HF) due to a transient AF attack itself, and that accounted for 21% of all HF events. The BIVP% during the AF attacks was significantly lower than that during SR (p < 0.05). When compared to the SR groups, patients with intermittent AF had a significantly higher risk of developing HF or death (hazard ratio: 2.2; 95% confidence interval: 1.3 to 3.8). However, the patients who received a BIVP% of ≥90% during AF attacks were comparable to those with SR (hazard ratio: 1.2; 95% confidence interval: 0.4 to 3.0). A substantial number of patients develop...Continue Reading

References

Mar 9, 2005·The New England Journal of Medicine·John G F ClelandUNKNOWN Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators
Dec 20, 2005·Journal of the American College of Cardiology·Berry M van GelderNico H J Pijls
Sep 3, 2009·The New England Journal of Medicine·Arthur J MossUNKNOWN MADIT-CRT Trial Investigators
Feb 27, 2010·Journal of the American College of Cardiology·C Jan Willem BorleffsMartin J Schalij
Jan 8, 2011·Journal of the American College of Cardiology·Massimo SantiniUNKNOWN cardiological centers participating in ClinicalService Project
Feb 23, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Stephen B WiltonDerek V Exner
Mar 2, 2013·Journal of the American College of Cardiology·Laurence M EpsteinMelanie Maytin
Jan 28, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Michael O SweeneyJeroen J Bax
Mar 23, 2017·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Matthew M KalscheurSteven N Singh
Feb 1, 2018·The New England Journal of Medicine·Nassir F MarroucheUNKNOWN CASTLE-AF Investigators

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Citations

Jan 7, 2022·Circulation Journal : Official Journal of the Japanese Circulation Society·Akihiko NogamiUNKNOWN Japanese Circulation Society / the Japanese Heart Rhythm Society Joint Working Group

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