Document Detail


A Strategy to Achieve CRT Response in Permanent Atrial Fibrillation without Obligatory Atrioventricular Node Ablation.
MedLine Citation:
PMID:  22650352     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Cardiac resynchronization therapy (CRT) is an established method in patients with severe heart failure and wide QRS configuration, particularly during sinus rhythm (SR). In CRT patients with permanent atrial fibrillation (AF), there is no general consensus regarding the need for atrioventricular node (AVN) ablation. The aim of this study was to evaluate the benefit of CRT in permanent AF with and without AVN ablation. Methods: New York Heart Association classification, QRS duration, and echocardiographic parameters were assessed before and after CRT with a follow-up of 12 ± 3 months. Two hundred thirty patients in SR and 46 patients with permanent AF of 2.1 ± 0.5 years duration were studied. AVN ablation was performed only in AF patients with insufficient pharmacological rate control evidenced by ≤80 % ventricular stimulation. Results: Fifteen AF patients underwent AVN ablation. Biventricular pacing comparably improved functional status, left ventricular ejection fraction, and left ventricular end-diastolic dimensions in all treated groups. Biventricular stimulation percentage was 10% lower in pharmacologically treated AF patients over 1 year as compared to patients in SR and to AF patients undergoing AVN ablation, which did not affect outcome in this patient population. Conclusion: In patients with permanent AF and CRT, an AVN ablation strategy might not be strictly required in all patients. (PACE 2012;00:1-5).
Authors:
Frank Himmel; Michael Reppel; Kai Mortensen; Heribert Schunkert; Frank Bode
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-31
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  -     ISSN:  1540-8159     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-6-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
Affiliation:
Medizinische Klinik II, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
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