PMID- 11955841
OWN - NLM
STAT- MEDLINE
DCOM- 20020510
LR  - 20191210
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 39
IP  - 8
DP  - 2002 Apr 17
TI  - Cardiac resynchronization in patients with congestive heart failure and chronic 
      atrial fibrillation: effect of upgrading to biventricular pacing after chronic 
      right ventricular pacing.
PG  - 1258-63
AB  - OBJECTIVES: This study assessed the effects of biventricular pacing (BVP) on 
      ventricular function, functional status, quality of life and hospitalization in 
      patients with congestive heart failure (CHF), prior atrioventricular (AV) 
      junction ablation and right ventricular (RV) pacing performed for chronic atrial 
      fibrillation (AF). BACKGROUND: Although the benefit of BVP in CHF should 
      theoretically extend to the patient with chronic RV pacing and AF, to our 
      knowledge, no study has determined the effects of BVP on symptoms and ventricular 
      function in these patients. This patient population allows for the evaluation of 
      ventricular resynchronization independent of any BVP-induced changes on the AV 
      interval. METHODS: Twenty consecutive patients with severe CHF (ejection fraction 
      < or = 0.35, New York Heart Association [NYHA] functional class III or IV), prior 
      AV junction ablation and RV pacing performed for permanent AF of at least six 
      months' duration were studied. Electrocardiograms, echocardiograms, functional 
      status evaluations and quality of life surveys were completed before and at three 
      to six months after implant. RESULTS: The NYHA functional classification improved 
      29% (p < 0.001). The left ventricular (LV) ejection fraction increased 44% (p < 
      0.001), the LV diastolic diameter decreased 6.5% (p <0.003) and the end-systolic 
      diameter decreased 8.5% (p < 0.01). The number of hospitalizations decreased by 
      81% (p < 0.001). The scores on the Minnesota Living with Heart Failure survey 
      improved by 33% (p < 0.01). CONCLUSIONS: We conclude that BVP improves the LV 
      function and the symptoms of CHF in patients with permanent AF and chronic RV 
      pacing. These benefits are comparable to those described for patients in sinus 
      rhythm suggesting that BVP acts through ventricular resynchronization rather than 
      optimization of the AV delay.
FAU - Leon, Angel R
AU  - Leon AR
AD  - Carlyle Fraser Heart Center, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, Georgia 30365, USA. angel_leon@emory.edu
FAU - Greenberg, Jeffrey M
AU  - Greenberg JM
FAU - Kanuru, Narendra
AU  - Kanuru N
FAU - Baker, Cindy M
AU  - Baker CM
FAU - Mera, Fernando V
AU  - Mera FV
FAU - Smith, Andrew L
AU  - Smith AL
FAU - Langberg, Jonathan J
AU  - Langberg JJ
FAU - DeLurgio, David B
AU  - DeLurgio DB
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/*complications/mortality/*therapy
MH  - *Cardiac Pacing, Artificial
MH  - Chronic Disease
MH  - Defibrillators, Implantable
MH  - Device Removal
MH  - Echocardiography
MH  - Electric Impedance
MH  - Electrocardiography
MH  - Electrodes, Implanted
MH  - Female
MH  - Follow-Up Studies
MH  - Georgia
MH  - Heart Failure/*complications/mortality/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Quality of Life
MH  - Stroke Volume/physiology
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Ventricular Function, Left/physiology
EDAT- 2002/04/17 10:00
MHDA- 2002/05/11 10:01
CRDT- 2002/04/17 10:00
PHST- 2002/04/17 10:00 [pubmed]
PHST- 2002/05/11 10:01 [medline]
PHST- 2002/04/17 10:00 [entrez]
AID - S0735109702017795 [pii]
AID - 10.1016/s0735-1097(02)01779-5 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2002 Apr 17;39(8):1258-63. doi: 10.1016/s0735-1097(02)01779-5.