AV nodal ablation was associated with a substantial reduction in all-cause mortality and cardiovascular mortality and with improvements in New York Heart Association functional class compared with medical therapy in CRT-AF patients .
OBJECTIVES The aim of this study was to systematic ally review the medical literature to evaluate the impact of AV nodal ablation in patients with heart failure and coexistent atrial fibrillation ( AF ) receiving cardiac resynchronization therapy ( CRT ) .
BACKGROUND CRT has a substantial evidence base in patients in sinus rhythm with significant systolic dysfunction , symptomatic heart failure , and prolonged QRS duration .
The role of CRT is less well established in AF patients with coexistent heart failure .
AV nodal ablation has recently been suggested to improve outcomes in this group .
Long-term benefits of biventricular pacing in congestive heart failure: results from the MUltisite STimulation in cardiomyopathy (MUSTIC) study.
OBJECTIVES The main objective of this study was to assess if the benefits of biventricular ( BiV ) pacing observed during the crossover phase were sustained over 12 months . BACKGROUND MUltisite STimulation In Cardiomyopathies ( MUSTIC ) is a r and omized controlled study intended to evaluate the effects of BiV pacing in patients with New York Heart Association ( NYHA ) class III heart failure and intraventricular conduction delay . METHODS Of 131 patients included , 42/67 in sinus rhythm ( SR ) and 33/64 in atrial fibrillation ( AF ) were followed up longitudinally at 9 and 12 months by 6-min walked distance , peak oxygen uptake ( peak VO(2 ) ) , quality of life by the Minnesota score , NYHA class , echocardiography , and left ventricular ejection fraction by radionuclide technique . RESULTS At 12 months , all SR and 88 % of AF patients were programmed to BiV pacing . Compared with baseline , the 6-min walked distance increased by 20 % ( SR ) ( p = 0.0001 ) and 17 % ( AF ) ( p = 0.004 ) ; the peak VO(2 ) by 11 % ( SR ) and 9 % ( AF ) ; quality of life improved by 36 % ( SR ) ( p = 0.0001 ) and 32 % ( AF ) ( p = 0.002 ) ; NYHA class improved by 25 % ( SR ) ( p = 0.0001 ) and 27 % ( AF ) ( p = 0.0001 ) . The ejection fraction improved by 5 % ( SR ) and 4 % ( AF ) . Mitral regurgitation decreased by 45 % ( SR ) and 50 % ( AF ) . CONCLUSIONS The clinical benefits of BiV pacing appeared to be significantly maintained over a 12-month follow-up period
AV nodal ablation was associated with a substantial reduction in all-cause mortality and cardiovascular mortality and with improvements in New York Heart Association functional class compared with medical therapy in CRT-AF patients .
OBJECTIVES The aim of this study was to systematic ally review the medical literature to evaluate the impact of AV nodal ablation in patients with heart failure and coexistent atrial fibrillation ( AF ) receiving cardiac resynchronization therapy ( CRT ) .
BACKGROUND CRT has a substantial evidence base in patients in sinus rhythm with significant systolic dysfunction , symptomatic heart failure , and prolonged QRS duration .
The role of CRT is less well established in AF patients with coexistent heart failure .
AV nodal ablation has recently been suggested to improve outcomes in this group .