Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation

K. Khadjooi, P. W. Foley, S. Chalil, J Anthony, Rhea Smith, Michael Frenneaux, F. Leyva

Research output: Contribution to journalArticle

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Abstract

Objective: To compare the effects of cardiac resynchronisation therapy (CRT) in patients with heart failure (HF) in either atrial fibrillation (AF) or sinus rhythm (SR).

Design: Prospective observational study.

Patients: 295 consecutive patients with HF (permanent AF in 66, paroxysmal AF in 20, SR in 209; New York Heart Association (NYHA) class III or IV; left ventricular ejection fraction (LVEF) <= 35%, QRS >= 120 ms).

Interventions: All patients underwent CRT without atrioventricular junction ablation.

Main outcome measures: The primary end point was the composite of cardiovascular death or unplanned hospitalisation for major cardiovascular events. Secondary end points included the composite of cardiovascular death or hospitalisation for worsening HF. Cardiovascular mortality, total mortality and changes in NYHA class, 6-minute walking distance, quality of life (Minnesota Living with Heart Failure questionnaire) and echocardiographic variables were also considered.

Results: Over a follow-up period of up to 6.8 years, no differences emerged between patients in AF or SR in any of the mortality or morbidity end points. The AF and SR groups derived similar improvements in mean NYHA class (-1.3 vs -1.2), 6-minute walking distance (92.3 vs 78.4 m) and quality of life scores (-25.2 vs -18.7) (all p<0.001). In both the AF and the SR groups, reductions were seen in left ventricular end-systolic (-25.9 vs -34.5 ml, both p<0.001) and end-diastolic (-20.2 ml, p = 0.001 vs 26.2 ml, p<0.001) volumes and improvements in LVEF (4.69% vs 7.86%, both p<0.001).

Conclusions: Cardiac resynchronisation therapy leads to similar prognostic and symptomatic benefits in patients in AF and SR, even without atrioventricular junction ablation. Echocardiographic improvements are also comparable.

Original languageEnglish
Pages (from-to)879-883
Number of pages5
JournalHeart
Volume94
Issue number7
DOIs
Publication statusPublished - Jul 2008

Keywords

  • congestive-heart-failure
  • resynchronization therapy
  • sinus rhythm
  • mortality
  • ablation
  • cardiomyopathy
  • stimulation
  • progression
  • delay
  • trial

Cite this

Khadjooi, K., Foley, P. W., Chalil, S., Anthony, J., Smith, R., Frenneaux, M., & Leyva, F. (2008). Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation. Heart, 94(7), 879-883. https://doi.org/10.1136/hrt.2007.129429

Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation. / Khadjooi, K.; Foley, P. W.; Chalil, S.; Anthony, J; Smith, Rhea; Frenneaux, Michael; Leyva, F.

In: Heart, Vol. 94, No. 7, 07.2008, p. 879-883.

Research output: Contribution to journalArticle

Khadjooi, K, Foley, PW, Chalil, S, Anthony, J, Smith, R, Frenneaux, M & Leyva, F 2008, 'Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation', Heart, vol. 94, no. 7, pp. 879-883. https://doi.org/10.1136/hrt.2007.129429
Khadjooi K, Foley PW, Chalil S, Anthony J, Smith R, Frenneaux M et al. Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation. Heart. 2008 Jul;94(7):879-883. https://doi.org/10.1136/hrt.2007.129429
Khadjooi, K. ; Foley, P. W. ; Chalil, S. ; Anthony, J ; Smith, Rhea ; Frenneaux, Michael ; Leyva, F. / Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation. In: Heart. 2008 ; Vol. 94, No. 7. pp. 879-883.
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abstract = "Objective: To compare the effects of cardiac resynchronisation therapy (CRT) in patients with heart failure (HF) in either atrial fibrillation (AF) or sinus rhythm (SR).Design: Prospective observational study.Patients: 295 consecutive patients with HF (permanent AF in 66, paroxysmal AF in 20, SR in 209; New York Heart Association (NYHA) class III or IV; left ventricular ejection fraction (LVEF) <= 35{\%}, QRS >= 120 ms).Interventions: All patients underwent CRT without atrioventricular junction ablation.Main outcome measures: The primary end point was the composite of cardiovascular death or unplanned hospitalisation for major cardiovascular events. Secondary end points included the composite of cardiovascular death or hospitalisation for worsening HF. Cardiovascular mortality, total mortality and changes in NYHA class, 6-minute walking distance, quality of life (Minnesota Living with Heart Failure questionnaire) and echocardiographic variables were also considered.Results: Over a follow-up period of up to 6.8 years, no differences emerged between patients in AF or SR in any of the mortality or morbidity end points. The AF and SR groups derived similar improvements in mean NYHA class (-1.3 vs -1.2), 6-minute walking distance (92.3 vs 78.4 m) and quality of life scores (-25.2 vs -18.7) (all p<0.001). In both the AF and the SR groups, reductions were seen in left ventricular end-systolic (-25.9 vs -34.5 ml, both p<0.001) and end-diastolic (-20.2 ml, p = 0.001 vs 26.2 ml, p<0.001) volumes and improvements in LVEF (4.69{\%} vs 7.86{\%}, both p<0.001).Conclusions: Cardiac resynchronisation therapy leads to similar prognostic and symptomatic benefits in patients in AF and SR, even without atrioventricular junction ablation. Echocardiographic improvements are also comparable.",
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T1 - Long-term effects of cardiac resynchronisation therapy in patients with atrial fibrillation

AU - Khadjooi, K.

AU - Foley, P. W.

AU - Chalil, S.

AU - Anthony, J

AU - Smith, Rhea

AU - Frenneaux, Michael

AU - Leyva, F.

PY - 2008/7

Y1 - 2008/7

N2 - Objective: To compare the effects of cardiac resynchronisation therapy (CRT) in patients with heart failure (HF) in either atrial fibrillation (AF) or sinus rhythm (SR).Design: Prospective observational study.Patients: 295 consecutive patients with HF (permanent AF in 66, paroxysmal AF in 20, SR in 209; New York Heart Association (NYHA) class III or IV; left ventricular ejection fraction (LVEF) <= 35%, QRS >= 120 ms).Interventions: All patients underwent CRT without atrioventricular junction ablation.Main outcome measures: The primary end point was the composite of cardiovascular death or unplanned hospitalisation for major cardiovascular events. Secondary end points included the composite of cardiovascular death or hospitalisation for worsening HF. Cardiovascular mortality, total mortality and changes in NYHA class, 6-minute walking distance, quality of life (Minnesota Living with Heart Failure questionnaire) and echocardiographic variables were also considered.Results: Over a follow-up period of up to 6.8 years, no differences emerged between patients in AF or SR in any of the mortality or morbidity end points. The AF and SR groups derived similar improvements in mean NYHA class (-1.3 vs -1.2), 6-minute walking distance (92.3 vs 78.4 m) and quality of life scores (-25.2 vs -18.7) (all p<0.001). In both the AF and the SR groups, reductions were seen in left ventricular end-systolic (-25.9 vs -34.5 ml, both p<0.001) and end-diastolic (-20.2 ml, p = 0.001 vs 26.2 ml, p<0.001) volumes and improvements in LVEF (4.69% vs 7.86%, both p<0.001).Conclusions: Cardiac resynchronisation therapy leads to similar prognostic and symptomatic benefits in patients in AF and SR, even without atrioventricular junction ablation. Echocardiographic improvements are also comparable.

AB - Objective: To compare the effects of cardiac resynchronisation therapy (CRT) in patients with heart failure (HF) in either atrial fibrillation (AF) or sinus rhythm (SR).Design: Prospective observational study.Patients: 295 consecutive patients with HF (permanent AF in 66, paroxysmal AF in 20, SR in 209; New York Heart Association (NYHA) class III or IV; left ventricular ejection fraction (LVEF) <= 35%, QRS >= 120 ms).Interventions: All patients underwent CRT without atrioventricular junction ablation.Main outcome measures: The primary end point was the composite of cardiovascular death or unplanned hospitalisation for major cardiovascular events. Secondary end points included the composite of cardiovascular death or hospitalisation for worsening HF. Cardiovascular mortality, total mortality and changes in NYHA class, 6-minute walking distance, quality of life (Minnesota Living with Heart Failure questionnaire) and echocardiographic variables were also considered.Results: Over a follow-up period of up to 6.8 years, no differences emerged between patients in AF or SR in any of the mortality or morbidity end points. The AF and SR groups derived similar improvements in mean NYHA class (-1.3 vs -1.2), 6-minute walking distance (92.3 vs 78.4 m) and quality of life scores (-25.2 vs -18.7) (all p<0.001). In both the AF and the SR groups, reductions were seen in left ventricular end-systolic (-25.9 vs -34.5 ml, both p<0.001) and end-diastolic (-20.2 ml, p = 0.001 vs 26.2 ml, p<0.001) volumes and improvements in LVEF (4.69% vs 7.86%, both p<0.001).Conclusions: Cardiac resynchronisation therapy leads to similar prognostic and symptomatic benefits in patients in AF and SR, even without atrioventricular junction ablation. Echocardiographic improvements are also comparable.

KW - congestive-heart-failure

KW - resynchronization therapy

KW - sinus rhythm

KW - mortality

KW - ablation

KW - cardiomyopathy

KW - stimulation

KW - progression

KW - delay

KW - trial

U2 - 10.1136/hrt.2007.129429

DO - 10.1136/hrt.2007.129429

M3 - Article

VL - 94

SP - 879

EP - 883

JO - Heart

JF - Heart

SN - 1355-6037

IS - 7

ER -