Abstract 3077: Does Baseline Atrial Rhythm Predict Long Term Clinical Response To Cardiac Resynchronization Therapy?
Background: Cardiac resynchronization therapy (CRT) is a recommended treatment in patients (pts) with advanced heart failure (HF), left ventricular systolic dysfunction, wide QRS and stable sinus rhythm (SR). Data in patients with permanent atrial fibrillation are scarce despite the high proportion of advanced heart failure pts with AF. The aim of this prospective study was to compare the long term efficacy of CRT according baseline atrial rhythm in a large population of HF pts implanted with CRT devices.
Results: From 1994 to mid 2006, 483 pts with guidelines-recommended CRT indications were included. 146 pts (30%) had permanent AF and 337 pts (70%) were in SR. Mean age (69 ± 9 years) and % of ischemic aetiology (37%) were similar in both groups. All AF had spontaneous or radiofrequency induced AV block thus ensuring permanent biventricular capture. The mean FU time was 2.2 ± 1.8 years in AF and 2.2 ± 1.7 years in SR pts.
Conclusion : The long-term clinical benefit of CRT was similar in AF and SR for symptoms, exercise tolerance and reverse LV remodelling, but the survival rate was significantly lower in AF pts as compared to SR pts (p= 0.013).