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 : SCJ
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)
- author
- Jacobsson, Jonatan
LU
; Platonov, Pyotr G
LU
; Reitan, Christian
LU
; Carlsson, Jonas
and Borgquist, Rasmus
LU
- organization
- publishing date
- 2017
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian cardiovascular journal : SCJ
- volume
- 51
- issue
- 2
- pages
- 8 pages
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:27841021
- 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
- 2024-05-17 16:56:52
@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 : SCJ}},
title = {{Atrial high rate episodes predict clinical outcome in patients with cardiac resynchronization therapy}},
url = {{https://lup.lub.lu.se/search/files/22012258/17356100.pdf}},
doi = {{10.1080/14017431.2016.1260768}},
volume = {{51}},
year = {{2017}},
}