Cardiac resynchronization therapy defibrillators in patients with permanent atrial fibrillation

• DOI: 10.1002/ehf2.13599
• Publication Date: 2021-09-13T04:37:38Z
• Authors: Antonio Rapacciuolo; Saverio Iacopino; Antonio D'Onofrio; Antonio Curnis; Ennio C. Pisanò; Mauro Biffi; Paolo Della Bella; Antonio Dello Russo; Fabrizio Caravati; Gabriele Zanotto; Valeria Calvi; Giovanni Rovaris; Gaetano Senatore; Daniele Nicolis; Matteo Santamaria; Massimo Giammaria; Giampiero Maglia; Antonio Duca; Giuseppe Ammirati; Salvo Andrea Romano; Marcello Piacenti; Eduardo Celentano; Giovanni Bisignani; Paola Vaccaro; Gennaro Miracapillo; Matteo Bertini; Gerardo Nigro; Daniele Giacopelli; Alessio Gargaro; Caterina Bisceglia
• Keywords: Defibrillation shock; Male; Cardiac resynchronization therapy; Heart rate; Heart failure; Atrial fibrillation; Cardiac resynchronization therapy; Defibrillation shock; Heart failure; Heart rate; Original Articles; Atrial fibrillation; 3. Good health; Cardiac Resynchronization Therapy; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; RC666-701; Atrial Fibrillation; Diseases of the circulatory (Cardiovascular) system; Humans; Aged; Defibrillators; Retrospective Studies

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