Causes of non-response to cardiac resynchronization therapy in heart failure patients with permanent atrial fibrillation / 中华心血管病杂志
Chinese Journal of Cardiology
; (12): 757-761, 2012.
Article
en Zh
| WPRIM
| ID: wpr-326426
Biblioteca responsable:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the long-term effects and analyze causes of non-response to cardiac resynchronization therapy (CRT) in heart failure (HF) patients with permanent atrial fibrillation (AF).</p><p><b>METHODS</b>Thirty-three patients with HF and AF [29 men, mean age (61 ± 10) years, NYHA class III or IV, left ventricular ejection fraction (LVEF) ≤ 35%, QRS ≥ 120 ms in 31 cases] underwent bi-ventricular pacing (n = 26) or bi-ventricular pacing and atrioventricular node ablation (AVN-ablation, n = 7) were included in this study. Non-response was defined: the increase of left ventricular ejection fraction (LVEF) was less than 15%. Patients were followed-up for 4 years.</p><p><b>RESULTS</b>Six patients died during follow up. Non-responder to CRT was observed in 6 out of 27 survived patients (22.22%). Six out of 7 patients underwent AVN-ablation were in responder group and 1 in non-responder group. Comparing with responder group, the baseline LVEF was significantly higher (37% vs. 32%, P = 0.003), and the history of HF was significantly longer (6.3 years vs. 4.1 years, P = 0.039), pulmonary artery pressure was significantly higher (53 vs. 32 mm Hg, P = 0.027), bi-ventricular pacing percentage (BIVP%) was significantly lower (75.86% vs. 91.73%, P = 0.007) in non-responder group.</p><p><b>CONCLUSIONS</b>Higher LVEF, longer HF history, higher pulmonary artery pressure and lower BIVP% are factors linked with non-responses to CRT in this patient cohort. CRT plus AVN-ablation is associated with high response rate to CRT in this patient cohort.</p>
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Fibrilación Atrial
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Terapéutica
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Modelos Logísticos
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Resultado del Tratamiento
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Terapia de Resincronización Cardíaca
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Insuficiencia Cardíaca
Tipo de estudio:
Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
Idioma:
Zh
Revista:
Chinese Journal of Cardiology
Año:
2012
Tipo del documento:
Article