Advanced

Atrial high rate episodes predict clinical outcome in patients with cardiac resynchronization therapy

Jacobsson, Jonatan LU ; Platonov, Pyotr G LU ; Reitan, Christian LU ; Carlsson, Jonas and Borgquist, Rasmus LU (2017) In Scandinavian cardiovascular journal : SCJ1997-01-01+01:00 51(2). p.74-81
Abstract

OBJECTIVES: Up to 50% of patients qualified for cardiac resynchronization therapy (CRT) have documented atrial fibrillation (AF) prior to CRT-implantation. This finding is associated with worse prognosis but few studies have evaluated the importance of post-implant device-detected AF. This study aimed to assess the prognostic impact of device-detected atrial high rate episodes (AHRE), as a surrogate for atrial fibrillation (AF).

DESIGN: Data was retrospectively obtained from consecutive patients receiving CRT. Baseline clinical data and data from CRT device-interrogations, performed at a median of 12.2 months after CRT-implantation, were evaluated with regard to prediction of the composite endpoint of death, heart transplant or... (More)

OBJECTIVES: Up to 50% of patients qualified for cardiac resynchronization therapy (CRT) have documented atrial fibrillation (AF) prior to CRT-implantation. This finding is associated with worse prognosis but few studies have evaluated the importance of post-implant device-detected AF. This study aimed to assess the prognostic impact of device-detected atrial high rate episodes (AHRE), as a surrogate for atrial fibrillation (AF).

DESIGN: Data was retrospectively obtained from consecutive patients receiving CRT. Baseline clinical data and data from CRT device-interrogations, performed at a median of 12.2 months after CRT-implantation, were evaluated with regard to prediction of the composite endpoint of death, heart transplant or appropriate shock therapy. Median follow-up time was 51 months post-implant.

RESULTS: The study included 377 patients. Preoperative AF was present in 49% and associated with worse outcome. The cumulative burden of AHRE at 12 months post-implant was an independent predictor of the primary endpoint. During the first 12 months after CRT-implantation, AHRE were detected in 25% of the patients with no preoperative diagnosis of AF. This finding was not associated with worse outcome.

CONCLUSIONS: In CRT recipients, the cumulative burden of AHRE during first year of follow-up was associated with worse long-term clinical outcome. Prospective trials are needed to determine if a rhythm control strategy is to be preferred in patients with CRT.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian cardiovascular journal : SCJ1997-01-01+01:00
volume
51
issue
2
pages
8 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85002971998
  • wos:000395166500003
ISSN
1651-2006
DOI
10.1080/14017431.2016.1260768
language
English
LU publication?
yes
id
659a116f-423f-427b-8111-a6d12d9b4757
date added to LUP
2016-11-24 21:14:05
date last changed
2018-01-07 11:36:56
@article{659a116f-423f-427b-8111-a6d12d9b4757,
  abstract     = {<p>OBJECTIVES: Up to 50% of patients qualified for cardiac resynchronization therapy (CRT) have documented atrial fibrillation (AF) prior to CRT-implantation. This finding is associated with worse prognosis but few studies have evaluated the importance of post-implant device-detected AF. This study aimed to assess the prognostic impact of device-detected atrial high rate episodes (AHRE), as a surrogate for atrial fibrillation (AF).</p><p>DESIGN: Data was retrospectively obtained from consecutive patients receiving CRT. Baseline clinical data and data from CRT device-interrogations, performed at a median of 12.2 months after CRT-implantation, were evaluated with regard to prediction of the composite endpoint of death, heart transplant or appropriate shock therapy. Median follow-up time was 51 months post-implant.</p><p>RESULTS: The study included 377 patients. Preoperative AF was present in 49% and associated with worse outcome. The cumulative burden of AHRE at 12 months post-implant was an independent predictor of the primary endpoint. During the first 12 months after CRT-implantation, AHRE were detected in 25% of the patients with no preoperative diagnosis of AF. This finding was not associated with worse outcome.</p><p>CONCLUSIONS: In CRT recipients, the cumulative burden of AHRE during first year of follow-up was associated with worse long-term clinical outcome. Prospective trials are needed to determine if a rhythm control strategy is to be preferred in patients with CRT.</p>},
  author       = {Jacobsson, Jonatan and Platonov, Pyotr G and Reitan, Christian and Carlsson, Jonas and Borgquist, Rasmus},
  issn         = {1651-2006},
  language     = {eng},
  number       = {2},
  pages        = {74--81},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian cardiovascular journal : SCJ1997-01-01+01:00},
  title        = {Atrial high rate episodes predict clinical outcome in patients with cardiac resynchronization therapy},
  url          = {http://dx.doi.org/10.1080/14017431.2016.1260768},
  volume       = {51},
  year         = {2017},
}