| Objective:To evaluate the effects of cardiac resynchronization therapy (CRT) in chronic congestive heart failure (CHF) patients who developed new-onset atrial fibrillation (AF) during follow-up one year after CRT.Methods:The study population consisted of 54 consecutive patients (42 men and 12 women; age 60.2±11.4 years) who had an indication for CRT with no history of AF. New-onset AF was defined as atrial high-rate episodes>180 bpm for more than 10 minutes as detected by the device, or as any AF documented on an electrocardiogram or Holter monitoring during follow-up. Patients were assigned to the AF group and to sinus rhythm (SR) group. Clinical and echocardiographic (Echo) evaluation was performed at baseline,after 6 months and 12 months of biventricular pacing.Results:12(22.2%)patients developed new-onset AF during follow-up one year. In the SR group, both the clinical and Echo indicators improved significantly after CRT (P<0.001). And in the AF group, there was also a significant improvement in NYHA functional class and left-ventricular (LV) ejection fraction during one-year follow up (P<0.001), as well as a reduction in LV end-diastolic diameter (P=0.017) and a raised trend in 6-min walk test (P=0.078), but there was no changes about the left-atrial (LA) diameter and mitral regurgitation. When compared to the SR group, patients in AF group showed a trend of less LA reverse remodeling (△LA, -0.1±5.3mm vs.-3.2±5.3mm, P=0.057).In logistic regression analysis, the percentage of atrail pacing (AP%) before AF occurrence was the only independent predictor of new-onset AF after CRT (P=0.008, OR=1.135, 95%CI 1.034-1.247)Conclusion:A substantial proportion of patients undergoing CRT developed new-onset AF. CRT could also improve these patients'heart function and increase activity amount, but play a poor role in LA reverse remodeling. The high AP% was the independent predictor of new-onset AF after CRT. |
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