Causes of non-response to cardiac resynchronization therapy in heart failure patients with permanent atrial fibrillation
10.3760/cma.j.issn.0253-3758.2012.09.008
- VernacularTitle:影响心力衰竭伴永久性心房颤动再同步治疗的相关因素分析
- Author:
Dong-Mei WANG
1
;
Hai-Bo YU
;
Shu-Ying QI
;
Chao DING
;
Gang WANG
;
Ya-Ling HAN
;
Hong-Yun ZANG
;
Lei-Sheng RU
Author Information
1. 白求恩国际和平医院
- Keywords:
Heart failure,congestive;
Atrial fibrillation;
Cardiac resynchronization therapy
- From:
Chinese Journal of Cardiology
2012;40(9):757-761
- CountryChina
- Language:Chinese
-
Abstract:
Objective 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).Methods 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 biventricular 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.Results 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.Conclusions 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.
