PMID- 38138281 OWN - NLM STAT- MEDLINE DCOM- 20231225 LR - 20240102 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 59 IP - 12 DP - 2023 Dec 15 TI - Predictors of Higher Frequency of Atrial Fibrillation in Patients with Cardiac Resynchronization Therapy. LID - 10.3390/medicina59122178 [doi] LID - 2178 AB - Background and Objectives: Cardiac resynchronization therapy (CRT) is one of the effective therapeutic options in the treatment of systolic heart failure (HF) with persistent symptoms. This prospective study was designed to determine whether CRT with biventricular pacing would reduce the risk of development of atrial fibrillation (AF) and to identify predictors for AF occurrence. Materials and Methods: The study population consisted of 126 patients, with a mean age of 63.8 +/- 9.1 years, who were eligible for CRT with biventricular pacing. Inclusion criteria were left ventricular ejection fraction (LVEF) /= 130 msec, and persistent HF symptoms of New York Heart Association (NYHA) II or III, despite optimal drug therapy. Patients were followed for a period of 24 months and were evaluated through clinical, electrocardiographic, and echocardiographic examination at baseline (prior to CRT implantation), as well as at 6 and 24 months post-implantation. At the end of follow-up, patients were divided into clinical responders and non-responders based on the following criteria: decrease in NYHA class >/= I, increase in LVEF >/= 10%, and reduction in QRS duration >/= 20 msec. Results: At follow-up, CRT was associated with a significant increase in LVEF (20.6 +/- 6.9% pre-implantation, 32.9 +/- 9.3% 24 months after implantation; p < 0.001), reduction in left ventricular end-diastolic and end-systolic diameters, and decrease in QRS duration (167.6 +/- 14.3 msec pre-implantation, 131.7 +/- 11.7 msec 24 months after implantation; p < 0.001), while left atrial (LA) diameter was slightly increased (p = 0.070). The frequency of AF occurrence increased after two years of follow-up (52.4% to 56.9%, p < 0.001). Significant predictors of AF occurrence in our study population were response to CRT-AF more frequent in non-responders (B = 8.134; p < 0.001), LA diameter-AF more frequent with larger LA diameter (B = 0.813; p < 0.001), and coronary sinus (CS) lead position-AF more frequent with posterolateral in comparison with lateral CS lead position (B = 5.159; p = 0.005). Conclusions: The results of our study provide new data on AF predictors in patients with HF subjected to CRT. There remains a permanent need for new predictors, which might help in patient selection and improvement in response rate. FAU - Grbovic, Aleksandra AU - Grbovic A AUID- ORCID: 0000-0001-5224-3440 AD - Dedinje Cardiovascular Institute, Heroja Milana Tepica 1, 11000 Belgrade, Serbia. FAU - Pavlovic, Sinisa AU - Pavlovic S AUID- ORCID: 0000-0002-1395-4407 AD - Dedinje Cardiovascular Institute, Heroja Milana Tepica 1, 11000 Belgrade, Serbia. FAU - Zugic, Vasko AU - Zugic V AD - Dedinje Cardiovascular Institute, Heroja Milana Tepica 1, 11000 Belgrade, Serbia. LA - eng PT - Journal Article DEP - 20231215 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 SB - IM MH - Humans MH - Middle Aged MH - Aged MH - *Cardiac Resynchronization Therapy/methods MH - *Atrial Fibrillation/complications/therapy MH - Stroke Volume MH - Prospective Studies MH - Treatment Outcome MH - Ventricular Function, Left MH - *Heart Failure/complications/therapy PMC - PMC10745040 OTO - NOTNLM OT - atrial fibrillation OT - cardiac resynchronization therapy OT - heart failure COIS- The authors declare no conflict of interest. EDAT- 2023/12/23 12:43 MHDA- 2023/12/25 06:42 PMCR- 2023/12/15 CRDT- 2023/12/23 01:15 PHST- 2023/09/27 00:00 [received] PHST- 2023/11/15 00:00 [revised] PHST- 2023/11/23 00:00 [accepted] PHST- 2023/12/25 06:42 [medline] PHST- 2023/12/23 12:43 [pubmed] PHST- 2023/12/23 01:15 [entrez] PHST- 2023/12/15 00:00 [pmc-release] AID - medicina59122178 [pii] AID - medicina-59-02178 [pii] AID - 10.3390/medicina59122178 [doi] PST - epublish SO - Medicina (Kaunas). 2023 Dec 15;59(12):2178. doi: 10.3390/medicina59122178.