Cardiac Resynchronisation Therapy in Patients with Atrial Fibrillation: Are Results as Good as in Patients with Sinus Rhythm?

  • C. Linde
Conference paper


In the last five years, controlled crossover trials and parallel comparisons of cardiac resynchronisation therapy (CRT) to control treatment have convincingly demonstrated symptomatic improvement in patients with severe heart failure and intraventricular conduction disturbances [1–5]. Almost all of these studies were performed exclusively in patients with sinus rhythm. There is, however, evidence from acute hemodynamic and long term studies that atrial fibrillation patients also benefit from CRT.


Atrial Fibrillation Cardiac Resynchronisation Therapy Heart Failure Patient Atrial Fibrillation Patient Severe Heart Failure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Cazeau S, Leclercq C, Lavergne T et al for the Multisite stimulation in Cardiomyopthy (2001) Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med 12:873–880CrossRefGoogle Scholar
  2. 2.
    Leclercq C, Walker S, Linde C et al (2001) Comparative effects of permanent biventricular and right univentricular pacing in heart failure patients with chronic atrial fibrillation. Eur Heart J 23:1780–1787CrossRefGoogle Scholar
  3. 3.
    Linde C, Leclercq C, Rex S et al (2002) Long-term benefits of biventricular pacing in congestive heart failure. Results from the MUSTIC (Multisite STimulation in Cardiomyopathy ) study. J Am Coll Cardiol 40:111–118PubMedCrossRefGoogle Scholar
  4. 4.
    Auricchio A, Stellbrink C, Sack S et al (2002) Chronic effects of hemodynamically optimised cardiac resynchronisation therapy on patients with heart failure and ventricular conduction delay. J Am Coll Cardiol 39:2026–2033PubMedCrossRefGoogle Scholar
  5. 5.
    Abraham WT, Fisher WG, Smith AL et al for the Miracle Investigators and Co-ordina-tors (2001) Multicentre InSync Randomised ClinicaL Evaluation (MIRACLE). Results of a randomised, double blind, controlled trial to assess cardiac resynchronisation therapy in heart failure patients. J Am Coll Cardiol 38:595–596CrossRefGoogle Scholar
  6. 6.
    Blanc JJ, Etienne Y, Gilard M et al (1997) Evaluation of different ventricular pacing sites in patients with severe heart failure. Circulation 96:3273–3277PubMedCrossRefGoogle Scholar
  7. 7.
    Etienne Y, Mansourati J, Gilard M (1999) Evaluation of left ventricular based pacing in patients with congestive heart failure and atrial fibrillation. Am J Cardiol 83:1138–1140PubMedCrossRefGoogle Scholar
  8. 8.
    Leclercq C, Cazeau S, Ritter P, Alonso C, Gras D, Mabo P, Lazarus A, Daubert JC (2000) A pilot experience with permanent biventricular pacing to treat advanced heart failure. Am Heart J 140:862–870PubMedCrossRefGoogle Scholar
  9. 9.
    Leclercq C, Linde C, Cazeau S et al (2002) Long term (2 years) clinical results of permanent biventricular pacing in patients with advanced heart failure and chronic atrial fibrillation: Results from the MUSTIC Trial. Pacing and Clin Electrophysiol 24:716Google Scholar
  10. 10.
    The CIBIS II Investigators and Committees (1999) The Cardiac Insufficiency Bisoprolol Study II (CIBIS II): a randomised trial. Lancet 353:9–13CrossRefGoogle Scholar
  11. 11.
    MERIT-HF Study Group (1999) Effects of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT.HF). Lancet 353:2001–2007CrossRefGoogle Scholar
  12. 12.
    Middlekauff HR, Stevenson WG, Stevenson LW (1991) Prognostic significance of atrial fibrillation in advanced heart failure. Circulation 84:40–48PubMedCrossRefGoogle Scholar
  13. 13.
    Baldasseroni S, de Biase L, Fresco C et al on behalf of the Italian Network on Congestive Heart Failure (IN-CHF) investigators (2002) Cumulative effect of complete left bundle branch block and chronical atrial fibrillation on 1-year mortality and hospitalisation in patients with congestive heart failure. Eur Heart J 23:1692–1698PubMedGoogle Scholar
  14. 14.
    Bristow MR for the Companion Steering Committee and Clinical Investigators (2000) Heart failure management using implantable devices for ventricular resynchronisa-tion: Comparison of Medical Therapy, Pacing and Defibrillation in Chronic Heart Failure (COMPANION) Trial. J Cardiac Failure 6:276–285CrossRefGoogle Scholar
  15. 15.
    Cleland JG, Daubert JC, Erdmann E et al (2001) The Care-HF study (Cardiac Resynchronisation in Heart Failure study): rationale, design and end-points. Eur J Heart Fail 3:481–489PubMedCrossRefGoogle Scholar
  16. 16.
    Daubert C, Linde C, Cazeau S et al (2002) Mortality in patients included in the MUSTIC study: Long term (> 2 years) follow up. Pacing and Clin Electrophysiol 24:558AGoogle Scholar

Copyright information

© Springer-Verlag Italia 2004

Authors and Affiliations

  • C. Linde
    • 1
  1. 1.Department of CardiologyKarolinska HospitalStockholmSweden

Personalised recommendations