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Does Permanent Atrial Fibrillation Modify Response to Cardiac Resynchronization Therapy in Heart Failure Patients?

2017-10Journal article Open access
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dc.contributor.authorAbreu, A
dc.contributor.authorOliveira, MM
dc.contributor.authorCunha, PS
dc.contributor.authorSanta Clara, H
dc.contributor.authorPortugal, G
dc.contributor.authorRodrigues, I
dc.contributor.authorSantos, V
dc.contributor.authorAlmeida-Morais, L
dc.contributor.authorSelas, M
dc.contributor.authorSoares, R
dc.contributor.authorBranco, LM
dc.contributor.authorCruz Ferreira, R
dc.contributor.authorMota Carmo, M
dc.date.accessioned2018-03-06T16:28:28Z
dc.date.available2018-03-06T16:28:28Z
dc.date.issued2017-10
dc.description.abstractINTRODUCTION: The benefits of cardiac resynchronization therapy (CRT) documented in heart failure (HF) may be influenced by atrial fibrillation (AF). We aimed to compare CRT response in patients in AF and in sinus rhythm (SR). METHODS: We prospectively studied 101 HF patients treated by CRT. Rates of clinical, echocardiographic and functional response, baseline NYHA class and variation, left ventricular ejection fraction, volumes and mass, atrial volumes, cardiopulmonary exercise test (CPET) duration (CPET dur), peak oxygen consumption (VO2max) and ventilatory efficiency (VE/VCO2 slope) were compared between AF and SR patients, before and at three and six months after implantation of a CRT device. RESULTS: All patients achieved ≥95% biventricular pacing, and 5.7% underwent atrioventricular junction ablation. Patients were divided into AF (n=35) and SR (n=66) groups; AF patients were older, with larger atrial volumes and lower CPET dur and VO2max before CRT. The percentages of clinical and echocardiographic responders were similar in the two groups, but there were more functional responders in the AF group (71% vs. 39% in SR patients; p=0.012). In SR patients, left atrial volume and left ventricular mass were significantly reduced (p=0.015 and p=0.021, respectively), whereas in AF patients, CPET dur (p=0.003) and VO2max (p=0.001; 0.083 age-adjusted) showed larger increases. CONCLUSION: Clinical and echocardiographic response rates were similar in SR and AF patients, with a better functional response in AF. Improvement in left ventricular function and volumes occurred in both groups, but left ventricular mass reduction and left atrial reverse remodeling were seen exclusively in SR patientspt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2017 Oct;36(10):687-694pt_PT
dc.identifier.doi10.1016/j.repc.2017.02.016pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2933
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Portuguesa de Cardiologiapt_PT
dc.relationExercise training following cardiac resynchronization therapy in patients with chronic heart failure
dc.subjectHSM CARpt_PT
dc.subjectAtrial Fibrillation/complicationspt_PT
dc.subjectCardiac Resynchronization Therapypt_PT
dc.subjectHeart Failure/complicationspt_PT
dc.subjectHeart Failure/therapy
dc.subjectProspective Studies
dc.subjectTreatment Outcome
dc.titleDoes Permanent Atrial Fibrillation Modify Response to Cardiac Resynchronization Therapy in Heart Failure Patients?pt_PT
dc.title.alternativeA Fibrilhação Auricular Modifica a Resposta à Terapêutica de Ressincronização Cardíaca em Doentes com Insuficiência Cardíaca?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleExercise training following cardiac resynchronization therapy in patients with chronic heart failure
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/3599-PPCDT/PTDC%2FDES%2F120249%2F2010/PT
oaire.citation.endPage694pt_PT
oaire.citation.issue10pt_PT
oaire.citation.startPage687pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume36pt_PT
oaire.fundingStream3599-PPCDT
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isProjectOfPublicationb4b3ce83-c10d-449f-ac5b-f6564f40039e
relation.isProjectOfPublication.latestForDiscoveryb4b3ce83-c10d-449f-ac5b-f6564f40039e

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