Cardiac resynchronization therapy and atrial fibrillation.

Abstract:

:Cardiac resynchronization therapy (CRT) is an important advance for the treatment of end-stage heart failure (HF). About 15-50% of HF is complicated by atrial fibrillation (AF), associated with worsened outcomes. The presence of AF may interfere with optimal delivery of CRT due to competition with biventricular (BiV) capture by conducted beats. Pacing algorithms in newer devices may not ensure consistent CRT delivery during periods of rapid ventricular rates. Atrioventricular junction ablation with permanent pacing eliminates interference by conducted beats and provides complete BiV capture and is associated with improved outcomes. Catheter ablation of AF is another promising alternative to maintain sinus rhythm in patients with AF and HF. However, the optimal indications for CRT delivery for patients in this complex cohort remain to be assessed in randomized clinical trials.

journal_name

Cardiol J

journal_title

Cardiology journal

authors

Kamath GS,Steinberg JS

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

4-10

issue

1

issn

1897-5593

journal_volume

16

pub_type

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