Is cardiac resynchronization therapy an antiarrhythmic therapy for atrial fibrillation? A systematic review and meta-analysis
Open accessAbstract
The impact of cardiac resynchronization therapy (CRT) on atrial fibrillation (AF) burden is poorly characterized. To assess the influence of CRT on AF, we performed a systematic literature search in MEDLINE using the MeSH headings "cardiac resynchronization therapy" or "cardiac pacing, artificial" and "atrial fibrillation." Selected studies were peer-reviewed and written in English. Most studies enrolled patients meeting traditional CRT criteria. Ten observational studies and two secondary analyses of clinical trials were identified. Although ten studies suggest that CRT favorably impacts AF, one secondary analysis of a clinical trial showed no effect of CRT on new-onset AF. In a meta-analysis of three studies examining the effect of CRT on persistent or permanent AF, the combined rate of conversion from persistent or permanent AF to sinus rhythm was 0.107 (95 % confidence interval 0.069-0.163). Prospective studies, particularly among patients not meeting traditional CRT criteria, are needed.
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In some patients in heart failure treated with biventricular pacing (cardiac resynchronization therapy), AF can terminate.
“In some patients in heart failure treated with biventricular pacing (cardiac resynchronization therapy), AF can terminate, 571 although such a 'rhythm control' effect of cardiac resynchronization therapy is likely to be small and clearly needs confirmation.572”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [571]
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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., Falk, V., González-Juanatey, J. R., Harjola, V.-P., Jankowska, E. A., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw128 · Cited by 11,429 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
- Authors
- Hess, P. L., Jackson, K. P., Hasselblad, V., & Al-Khatib, S. M.
- Affiliations
- Duke University (US)
- Corresponding author
- Hess, Paul L.
- Venue
- Current Cardiology Reports
- Published
- 2013-01-10
- Volume
- 15
- Issue
- 2
- Pages
- 330-330
- ISSN
- 1523-3782 (ISSN-L)
- 1534-3170
- PMC
- PMC3685144
- OpenAlex
- W2004585701
- Cited by
- 38
- References
- 42
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 6 · 2017: 1 · 2016: 11 · 2015: 1 · 2014: 5 · 2013: 1
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Cardiology Reports (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5t32hl069749-20)
- National Heart, Lung, and Blood Institute (T32-HL069749)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- cardiac resynchronization therapy, atrial fibrillation, antiarrhythmic therapy, atrial fibrillation burden, conversion to sinus rhythm, persistent atrial fibrillation, permanent atrial fibrillation, new-onset atrial fibrillation, CRT indications
- MeSH terms
- Atrial Fibrillation, Humans, Treatment Outcome, Cardiac Resynchronization Therapy
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