The Epidemic of Inadequate Bi-Ventricular Pacing in Patients with Persistent or Permanent Atrial Fibrillation and Its Association with Mortality
Atrial Fibrillation Monday, June 9th, 2014CIRCEP: May 17, 2014
Background—We classified patients’ atrial fibrillation (AF), assessed its impact on bi-ventricular pacing (BIVP%), and determined if AF classification or BIVP% independently correlate with mortality in Cardiac Resynchronization Therapy Defibrillator (CRT-D) patients.
Methods and Results—CRT-D patients were classified as Permanent (daily mean AF burden ≥23 hours), Persistent (≥7 consecutive days of AF ≥23 hours/day), Paroxysmal (≥1day with AF ≥6 hours), or No/Little AF (all others) using device-detected AF during the 6 months post-implant. We evaluated subsequent all-cause mortality using a multivariable Cox proportional hazards regression. Among 54,019 patients (age 70±11, 73% male, follow-up 2.3±1.2 years), 8% of patients each had Permanent (N=4,449), Persistent (N=4,237), and Paroxysmal AF (N=4,219). A high proportion of patients with Permanent (69%) and Persistent (62%) AF did not achieve high BIVP (>98%). Read More
