Cardiac resynchronization therapy defibrillators in patients with permanent atrial fibrillation

被引：2

作者：

Rapacciuolo, Antonio ^{[1
]}

Iacopino, Saverio ^{[2
]}

D'Onofrio, Antonio ^{[3
]}

Curnis, Antonio ^{[4
]}

Pisano, Ennio C. ^{[5
]}

Biffi, Mauro ^{[6
]}

Della Bella, Paolo ^{[7
]}

Dello Russo, Antonio ^{[8
]}

Caravati, Fabrizio ^{[9
]}

Zanotto, Gabriele ^{[10
]}

Calvi, Valeria ^{[11
]}

Rovaris, Giovanni ^{[12
]}

Senatore, Gaetano ^{[13
]}

Nicolis, Daniele ^{[14
]}

Santamaria, Matteo ^{[15
]}

Giammaria, Massimo ^{[16
]}

Maglia, Giampiero ^{[17
]}

Duca, Antonio ^{[18
]}

Ammirati, Giuseppe ^{[1
]}

Romano, Salvo Andrea ^{[19
]}

Piacenti, Marcello ^{[20
]}

Celentano, Eduardo ^{[21
]}

Bisignani, Giovanni ^{[22
]}

Vaccaro, Paola ^{[23
]}

Miracapillo, Gennaro ^{[24
]}

Bertini, Matteo ^{[25
]}

Nigro, Gerardo ^{[26
]}

Giacopelli, Daniele ^{[27
,28
]}

Gargaro, Alessio ^{[27
]}

Bisceglia, Caterina ^{[7
]}

机构：

[1] Federico II Univ Naples, Dept Adv Biomed Sci, Corso Umberto I 40, I-80138 Naples, Italy

[2] Villa Maria Care & Res, Cotignola, Italy

[3] Osped Monaldi, Naples, Italy

[4] Spedali Civil Brescia, Brescia, Italy

[5] Osped Vito Fazzi, Lecce, Italy

[6] Policlinico St Orsola Malpighi, Bologna, Italy

[7] IRCCS San Raffaele Sci Inst, Milan, Italy

[8] Osped Riuniti, Ancona, Italy

[9] Osped Circolo Varese, ASST Sette Laghi, Varese, Italy

[10] Osped Mater Salutis, Legnago, Italy

[11] Az OU Policlin V Emanuele, Policlin G Rodolico, Catania, Italy

[12] Osped San Gerardo, Monza, Italy

[13] Osped Cirie, Cirie, Italy

[14] Osped Mantova, Mantua, Italy

[15] Gemelli Molise Hosp, Campobasso, Italy

[16] Osped Maria Vittoria, Turin, Italy

[17] Azienda Osped Pugliese Ciaccio, Catanzaro, Italy

[18] IRCCS Neurolesi Osped Piemonte, Messina, Italy

[19] Osped Desio, Desio, Italy

[20] Fdn Toscana Gabriele Monasterio, Pisa, Italy

[21] Humanitas Gavazzeni, Bergamo, Italy

[22] Osped Ferrari, Castrovillari, Italy

[23] AOR Villa Sofia Cervello PO Cervello, Palermo, Italy

[24] Osped Grosseto, Grosseto, Italy

[25] Univ Ferrara, S Anna Hosp, Ferrara, Italy

[26] Univ Campania Luigi Vanvitelli, Monaldi Hosp, Naples, Italy

[27] Biotronik Italia Spa, Vimodrone, Italy

[28] Univ Padua, Padua, Italy

来源：

ESC HEART FAILURE | 2021年 / 8卷 / 06期

关键词：

Atrial fibrillation; Cardiac resynchronization therapy; Heart failure; Heart rate; Defibrillation shock; HEART-FAILURE PATIENTS; DIAGNOSIS; RELEVANCE; EFFICACY;

D O I：

10.1002/ehf2.13599

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims There are conflicting data on the benefit of cardiac resynchronization therapy (CRT) in heart failure (HF) patients with permanent atrial fibrillation (AF). We aimed to compare patient outcomes according to the presence or absence of permanent AF at device implantation. Methods and results We retrospectively analysed remote monitoring data from 1141 CRT defibrillators. Propensity score with inverse-probability weighting method was used to balance AF and sinus rhythm (SR) groups. Analysis endpoints included total mortality, appropriate defibrillation shocks, and CRT percentage. There were 229 patients (20.1%) in the AF group and 912 patients (79.9%) in the SR group. Compared with SR patients, AF patients were older (median age, 77 vs. 72 years, P < 0.001), more frequently male (82.5% vs. 75.5%, P = 0.02), and had higher heart rate (75.7 vs. 71.0 b.p.m., P < 0.001). Of the 229 AF patients, 162 (70.7%) received suboptimal CRT (<98%) and 67 (29.3%) had adequate CRT (>= 98%). During a median follow-up of 24 months, total mortality did not differ between AF and SR groups (propensity-score-weighted hazard ratio, HR 1.32 [95% confidence interval, 0.82-2.15], P = 0.25). The risk of appropriate shocks was significantly higher in the AF group with <98% CRT than in the SR group (weighted-HR, 1.99 [1.21-3.26], P = 0.006) and was similar in the AF group with >= 98% CRT versus the SR group (1.29 [0.66-2.53], P = 0.45). During follow-up, sinus rhythm was recovered in 23 patients in the AF group (10%) after a median time of 106 (42-256) days. The rate of sinus rhythm recovery in the AF group was 4.5 (95% CI, 2.8-6.7) per 100 patient-years; the rate of permanent AF occurrence in the SR group was 2.5 (95% CI, 1.9-3.3) per 100 patient-years. Conclusions Although mortality was similar across patient groups, patients with permanent AF and suboptimal CRT had twofold higher risk of appropriate shocks than SR patients or AF patients with CRT >= 98%.

引用

页码：5204 / 5212

页数：9

共 22 条

[1] A Tutorial and Case Study in Propensity Score Analysis: An Application to Estimating the Effect of In-Hospital Smoking Cessation Counseling on Mortality [J].

Austin, Peter C. .

MULTIVARIATE BEHAVIORAL RESEARCH, 2011, 46 (01) :119-151

[2] The role of atrial sensing for new-onset atrial arrhythmias diagnosis and management in single-chamber implantable cardioverter-defibrillator recipients: Results from the THINGS registry [J].

Biffi, Mauro ;

Iori, Matteo ;

De Maria, Elia ;

Bolognesi, Maria Giulia ;

Placci, Angelo ;

Calvi, Valeria ;

Allocca, Giuseppe ;

Ammendola, Ernesto ;

Carinci, Valeria ;

Boggian, Giulio ;

Saporito, Davide ;

Grassini, Diego ;

Giacopelli, Daniele ;

Statuto, Giovanni ;

Ziacchi, Matteo .

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2020, 31 (04) :846-853

[3] Incidence and clinical relevance of uncontrolled ventricular rate during atrial fibrillation in heart failure patients treated with cardiac resynchronization therapy [J].

Boriani, Giuseppe ;

Gasparini, Maurizio ;

Landolina, Maurizio ;

Lunati, Maurizio ;

Proclemer, Alessandro ;

Lonardi, Gabriele ;

Iacopino, Saverio ;

Rahue, Werner ;

Biffi, Mauro ;

DiStefano, Paola ;

Grammatico, Andrea ;

Santini, Massimo .

EUROPEAN JOURNAL OF HEART FAILURE, 2011, 13 (08) :868-876

[4] The effect of cardiac resynchronization on morbidity and mortality in heart failure [J].

Cleland, JGF ;

Daubert, J ;

Erdmann, E ;

Freemantle, N ;

Gras, D ;

Kappenberger, L ;

Tavazzi, L ;

Cleland, JGF ;

Daubert, JC ;

Erdmann, E ;

Gras, D ;

Kappenberger, L ;

Klein, W ;

Tavazzi, L ;

Poole-Wilson, PA ;

Rydén, L ;

Wedel, H ;

Wellens, HJJ ;

Uretsky, B ;

Thygesen, K ;

Böcker, D ;

Marijianowski, MMH ;

Freemantle, N ;

Calvert, MJ ;

Christ, G ;

Fruhwald, F ;

Hofmann, R ;

Krypta, A ;

Leisch, F ;

Pacher, R ;

Rauscha, F ;

Tavernier, R ;

Thomsen, PEB ;

Boesgaard, S ;

Eiskjær, H ;

Esperen, GT ;

Haarbo, J ;

Hagemann, A ;

Korup, E ;

Moller, M ;

Mortensen, P ;

Sogaard, P ;

Vesterlund, T ;

Huikuri, H ;

Niemelä, KI ;

Toivonen, L ;

Bauer, F ;

Cohen-Solal, A ;

Crocq, C ;

Djiane, P .

NEW ENGLAND JOURNAL OF MEDICINE, 2005, 352 (15) :1539-1549

[5] CRT Survey II: a European Society of Cardiology survey of cardiac resynchronisation therapy in 11 088 patients-who is doing what to whom and how? [J].

Dickstein, Kenneth ;

Normand, Camilla ;

Auricchio, Angelo ;

Bogale, Nigussie ;

Cleland, John G. ;

Gitt, Anselm K. ;

Stellbrink, Christoph ;

Anker, Stefan D. ;

Filippatos, Gerasimos ;

Gasparini, Maurizio ;

Hindricks, Gerhard ;

Lundqvist, Carina Blomstrom ;

Ponikowski, Piotr ;

Ruschitzka, Frank ;

Botto, Giovanni Luca ;

Bulava, Alan ;

Duray, Gabor ;

Israel, Carsten ;

Leclercq, Christophe ;

Margitfalvi, Peter ;

Cano, Oscar ;

Plummer, Chris ;

Sarigul, Nedim Umutay ;

Sterlinski, Maciej ;

Linde, Cecilia .

EUROPEAN JOURNAL OF HEART FAILURE, 2018, 20 (06) :1039-1051

[6] Cardiac Resynchronization Therapy in Patients With Atrial Fibrillation [J].

Gasparini, Maurizio ;

Leclercq, Christophe ;

Lunati, Maurizio ;

Landolina, Maurizio ;

Auricchio, Angelo ;

Santini, Massimo ;

Boriani, Giuseppe ;

Lamp, Barbara ;

Proclemer, Alessandro ;

Curnis, Antonio ;

Klersy, Catherine ;

Leyva, Francisco .

JACC-HEART FAILURE, 2013, 1 (06) :500-507

[7] Resumption of sinus rhythm in patients with heart failure and permanent atrial fibrillation undergoing cardiac resynchronization therapy: a longitudinal observational study [J].

Gasparini, Maurizio ;

Steinberg, Jonathan S. ;

Arshad, Aysha ;

Regoli, Francois ;

Galimberti, Paola ;

Rosier, Arnaud ;

Daubert, Jean Claude ;

Klersy, Catherine ;

Kamath, Ganesh ;

Leclercq, Christophe .

EUROPEAN HEART JOURNAL, 2010, 31 (08) :976-983

[8] Cardiac resynchronization therapy and the relationship of percent biventricular pacing to symptoms and survival [J].

Hayes, David L. ;

Boehmer, John P. ;

Day, John D. ;

Gilliam, F. R., III ;

Heidenreich, Paul A. ;

Seth, Milan ;

Jones, Paul W. ;

Saxon, Leslie A. .

HEART RHYTHM, 2011, 8 (09) :1469-1475

[9] Cardiac Resynchronization Therapy in Patients With Permanent Atrial Fibrillation Results From the Resynchronization for Ambulatory Heart Failure Trial (RAFT) [J].

Healey, Jeff S. ;

Hohnloser, Stefan H. ;

Exner, Derek V. ;

Birnie, David H. ;

Parkash, Ratika ;

Connolly, Stuart J. ;

Krahn, Andrew D. ;

Simpson, Chris S. ;

Thibault, Bernard ;

Basta, Magdy ;

Philippon, Francois ;

Dorian, Paul ;

Nair, Girish M. ;

Sivakumaran, Soori ;

Yetisir, Elizabeth ;

Wells, George A. ;

Tang, Anthony S. L. .

CIRCULATION-HEART FAILURE, 2012, 5 (05) :566-570

[10] Device pacing diagnostics overestimate effective cardiac resynchronization therapy pacing results of the hOLter for Efficacy analysis of CRT (OLE CRT) study [J].

Hernandez-Madrid, Antonio ;

Facchin, Domenico ;

Klepfer, Ruth Nicholson ;

Ghosh, Subham ;

Matia, Roberto ;

Moreno, Javier ;

Locatelli, Alessandro .

HEART RHYTHM, 2017, 14 (04) :541-547

← 1 2 3 →