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Cited by 264

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Long-term survival in patients undergoing cardiac resynchronization therapy: the importance of performing atrio-ventricular junction ablation in patients with permanent atrial fibrillation

Open access
Gasparini, M., Auricchio, A., Metra, M., Regoli, F., Fantoni, C., Lamp, B., Curnis, A., Vogt, J., Klersy, C., for the Multicentre Longitudinal Observational Study (MILOS) Group·2008·European Heart Journal

Abstract

AIMS: To investigate the effects of cardiac resynchronization therapy (CRT) on survival in heart failure (HF) patients with permanent atrial fibrillation (AF) and the role of atrio-ventricular junction (AVJ) ablation in these patients. METHODS AND RESULTS: Data from 1285 consecutive patients implanted with CRT devices are presented: 1042 patients were in sinus rhythm (SR) and 243 (19%) in AF. Rate control in AF was achieved by either ablating the AVJ in 118 patients (AVJ-abl) or prescribing negative chronotropic drugs (AF-Drugs). Compared with SR, patients with AF were significantly older, more likely to be non-ischaemic, with higher ejection fraction, shorter QRS duration, and less often received ICD back-up. During a median follow-up of 34 months, 170/1042 patients in SR and 39/243 in AF died (mortality: 8.4 and 8.9 per 100 person-year, respectively). Adjusted hazard ratios were similar for all-cause and cardiac mortality [0.9 (0.57-1.42), P = 0.64 and 1.00 (0.60-1.66) P = 0.99, respectively]. Among AF patients, only 11/118 AVJ-abl patients died vs. 28/125 AF-Drugs patients (mortality: 4.3 and 15.2 per 100 person-year, respectively, P < 0.001). Adjusted hazard ratios of AVJ-abl vs. AF-Drugs was 0.26 [95% confidence interval (CI) 0.09-0.73, P = 0.010] for all-cause mortality, 0.31 (95% CI 0.10-0.99, P = 0.048) for cardiac mortality, and 0.15 (95% CI 0.03-0.70, P = 0.016) for HF mortality. CONCLUSION: Patients with HF and AF treated with CRT have similar mortality compared with patients in SR. In AF, AVJ ablation in addition to CRT significantly improves overall survival compared with CRT alone, primarily by reducing HF death.

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Metadata

Authors
Gasparini, M., Auricchio, A., Metra, M., Regoli, F., Fantoni, C., Lamp, B., Curnis, A., Vogt, J., Klersy, C., & for the Multicentre Longitudinal Observational Study (MILOS) Group
Venue
European Heart Journal
Published
2008-06-13
Volume
29
Issue
13
Pages
1644-1652
ISSN
  • 0195-668X (ISSN-L)
  • 1522-9645
OpenAlex
W2098429289
Cited by
264
References
5
FWCI
21.56
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Long-term survival in patients undergoing cardiac resynchronization therapy: the importance of performing atrio-ventricular junction ablation in patients with permanent atrial fibrillation. https://app.cochat.ai/papers/10.1093/eurheartj/ehn133
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Gasparini, M., Auricchio, A., Metra, M., Regoli, F., Fantoni, C., Lamp, B., Curnis, A., Vogt, J., Klersy, C., & for the Multicentre Longitudinal Observational Study (MILOS) Group. (2008). Long-term survival in patients undergoing cardiac resynchronization therapy: the importance of performing atrio-ventricular junction ablation in patients with permanent atrial fibrillation. European Heart Journal. https://doi.org/10.1093/eurheartj/ehn133

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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