| Cardiac resynchronization therapy in patients with permanent atrial fibrillation: results from the Resynchronization for Ambulatory Heart Failure Trial (RAFT). | |
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MedLine Citation:
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PMID: 22896584 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiac resynchronization (CRT) prolongs survival in patients with systolic heart failure and QRS prolongation. However, most trials excluded patients with permanent atrial fibrillation. METHODS AND RESULTS: The Resynchronization for Ambulatory Heart Failure Trial (RAFT) randomized patients to an implantable cardioverter defibrillator (ICD) or ICD+CRT, stratified by the presence of permanent atrial fibrillation. Patients with permanent atrial fibrillation were randomized to CRT-ICD (n=114) or ICD (n=115). Patients receiving a CRT-ICD were similar to those receiving an ICD: age (71.6±7.3 versus 70.4±7.7 years), left ventricular ejection fraction (22.9±5.3% versus 22.3±5.1%), and QRS duration (151.0±23.6 versus 153.4±24.7 ms). There was no difference in the primary outcome of death or heart failure hospitalization between those assigned to CRT-ICD versus ICD (hazard ratio, 0.96; 95% CI, 0.65-1.41; P=0.82). Cardiovascular death was similar between treatment arms (hazard ratio, 0.97; 95% CI, 0.55-1.71; P=0.91); however, there was a trend for fewer heart failure hospitalizations with CRT-ICD (hazard ratio, 0.58; 95% CI, 0.38-1.01; P=0.052). The change in 6-minute hall walk duration between baseline and 12 months was not different between treatment arms (CRT-ICD: 19±84 m versus ICD: 16±76 m; P=0.88). Patients treated with CRT-ICD showed a trend for a greater improvement in Minnesota Living with Heart Failure score between baseline and 6 months (CRT-ICD: 41±21 to 31±21; ICD: 33±20 to 28±20; P=0.057). CONCLUSIONS: Patients with permanent atrial fibrillation who are otherwise CRT candidates appear to gain minimal benefit from CRT-ICD compared with a standard ICD. |
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Authors:
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Jeff S Healey; Stefan H Hohnloser; Derek V Exner; David H Birnie; Ratika Parkash; Stuart J Connolly; Andrew D Krahn; Chris S Simpson; Bernard Thibault; Magdy Basta; Francois Philippon; Paul Dorian; Girish M Nair; Soori Sivakumaran; Elizabeth Yetisir; George A Wells; Anthony S L Tang; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2012-08-14 |
Journal Detail:
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Title: Circulation. Heart failure Volume: 5 ISSN: 1941-3297 ISO Abbreviation: Circ Heart Fail Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-09-19 Completed Date: 2012-12-03 Revised Date: 2013-04-26 |
Medline Journal Info:
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Nlm Unique ID: 101479941 Medline TA: Circ Heart Fail Country: United States |
Other Details:
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Languages: eng Pagination: 566-70 Citation Subset: IM |
Affiliation:
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Population Health Research Institute, Hamilton, Ontario, Canada. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00251251 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Action Potentials Aged Atrial Fibrillation / complications*, diagnosis, mortality, physiopathology Canada Cardiac Resynchronization Therapy* / adverse effects, mortality Cardiac Resynchronization Therapy Devices Defibrillators, Implantable Electric Countershock* / adverse effects, instrumentation, mortality Exercise Test Female Heart Failure / complications, diagnosis, mortality, physiopathology, therapy* Hospitalization Humans Kaplan-Meier Estimate Male Middle Aged Proportional Hazards Models Questionnaires Stroke Volume Time Factors Treatment Outcome Ventricular Function, Left |
| Comments/Corrections | |
Comment In:
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Circ Heart Fail. 2013 Mar 1;6(2):e22
[PMID:
23513051
]
Circ Heart Fail. 2012 Sep 1;5(5):547-9 [PMID: 22991403 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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