Abstract 2932: The Impact of Cardiac Resynchronization Therapy on Atrial Tachyarrhythmia Incidence In Congestive Heart Failure Patients
Introduction: Multiple studies have demonstrated the clinical benefits of cardiac resynchronization therapy (CRT) in heart failure (HF) patients. Whether there are also favorable effects on the incidence of atrial tachyarrhythmias (AT) remains unclear.
Objective: We examined the hypothesis that CRT reduces the incidence of atrial tachyarrhythmias in HF patients.
Methods: In a retrospective analysis of a prospectively-collected database evaluating the efficacy of a proprietary CRT-D device, we assessed the AT incidence in 133 patients (91% NYHA Class III, mean LVEF: 22.1 ± 0.6%) who had either a documented history or significant risk factors for AT. Values were obtained during the 3-month period prior to CRT-D implantation (baseline) and then at 1, 3, and 6 months post-implantation. Incidence for any period was defined as the number of patients with device-detected AT episodes per patient-month (number of patients observed x months of observation).
Results: The AT incidence at baseline was 0.103 patients/patient-month. Postoperative data at 1, 3, and 6 months follow-up were 0.085, 0.060, and 0.032 patients/patient-month respectively. Comparison of these values individually to the baseline revealed a statistically significant reduction in AT incidence by 3 months (Figure⇓). This reduction was associated with an improvement in NYHA classification by 1 or 2 classes in 57.3% of patients by 6 months. In addition, use of CHF medications decreased during the same period.
Conclusion: This retrospective analysis suggests that, in addition to symptomatic benefits, CRT progressively reduces atrial tachyarrhythmia incidence up to 6 months post-implantation.