Atrial fibrillation incidence and impact of biventricular pacing on long-term outcome in patients with heart failure treated with cardiac resynchronization therapy

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Jacobsson, JonatanLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Sahlgrenska University Hospital (författare)

Atrial fibrillation incidence and impact of biventricular pacing on long-term outcome in patients with heart failure treated with cardiac resynchronization therapy

Artikel/kapitelEngelska2019

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2019-08-13
Springer Science and Business Media LLC,2019

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LIBRIS-ID:oai:lup.lub.lu.se:b7e63e5d-8b50-44d3-9bb0-b018b2f6dcf9
https://lup.lub.lu.se/record/b7e63e5d-8b50-44d3-9bb0-b018b2f6dcf9URI
https://doi.org/10.1186/s12872-019-1169-1DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:141607424URI

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Språk:engelska
Sammanfattning på:engelska

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Background: In patients with cardiac resynchronization therapy (CRT), atrial fibrillation (AF) is associated with an unfavorable outcome and may cause loss of biventricular pacing (BivP). An effective delivery of BivP of more than 98% of all ventricular beats has been shown to be a major determinant of CRT-success. Methods: At a Swedish tertiary referral center, data was retrospectively obtained from patient registers, medical records and preoperative electrocardiograms. Data regarding AF and BivP during the first year of follow-up was assessed from CRT-device interrogations. No intra-cardiac electrograms were studied. Kaplan-Meier curves and Cox-regression analyses adjusted for age, etiology of heart failure, left ventricular ejection fraction, left bundle branch block and NYHA class were performed to assess the impact of AF and BivP on the risk of death or heart transplantation (HTx) at 10-years of follow-up. Results: Preoperative AF-history was found in 54% of the 379 included patients and was associated with, but did not independently predict death or HTx. The one-year incidence of new device-detected AF was 22% but not associated with poorer prognosis. At one-year, AF-history and BivP≤98%, was associated with a higher risk of death or HTx compared to patients without AF (HR 1.9, 95%CI 1.2-3.0, p = 0.005) whereas AF and BivP> 98% was not (HR 1.4, 95%CI 0.9-2.3, p = 0.14). Conclusions: In CRT-recipients, AF-history is common and associated with poor outcome. AF-history does not independently predict mortality and is probably only a marker of a more severe underlying disease. BivP≤98% during first-year of CRT-treatment independently predicts poor outcome thus further supporting the use of 98% threshold of BivP, which should be attained to maximize the benefits of CRT.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Atrial fibrillation
Atrial high rate episodes
Biventricular pacing
Cardiac resynchronization therapy
Heart failure
Mortality

Biuppslag (personer, institutioner, konferenser, titlar ...)

Reitan, ChristianKarolinska Institutet,Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-cr2 (författare)
Carlson, JonasLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)kard-jca (författare)
Borgquist, RasmusLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Aarhus University Hospital,Skåne University Hospital(Swepub:lu)medf-rbo (författare)
Platonov, Pyotr G.Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)kard-ppl (författare)
KardiologiSektion II (creator_code:org_t)

Sammanhörande titlar

Ingår i:BMC Cardiovascular Disorders: Springer Science and Business Media LLC191471-2261

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Av författaren/redakt...: Jacobsson, Jonat ...; Reitan, Christia ...; Carlson, Jonas; Borgquist, Rasmu ...; Platonov, Pyotr ...

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