Cardiac resynchronisation therapy in chronic atrial fibrillation: impact on left atrial size and reversal to sinus rhythm

Kiès, Philippine; Leclercq, C.; Bleeker, Gabe B.; Crocq, Christophe; Molhoek, Sander G.; Poulain, Cécile; Erven, L. Van; Bootsma, Marianne; Zeppenfeld, Katja; Wall, Ernst E. van der; Daubert, Jean Claude; Schalij, Martin J.; Bax, Jeroen J.

doi:10.1136/hrt.2005.064816

Cited by 59 publications

(40 citation statements)

References 32 publications

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“…Third, although 6MWD can be affected by a variety of factors related and unrelated to cardiopulmonary status (27), our analysis demonstrates that the association between ILA and reduced 6MWD is robust to adjustments for many potential confounders. The validity of our findings is additionally supported by our multivariate model, which includes many well-recognized factors associated with reduced 6MWD (e.g., obesity [28], resting heart rate [29], osteoarthritis [30], and atrial fibrillation [31]). Finally, ambulatory oxygen saturation was not measured during the 6MWT in COPDGene.…”

Section: Discussionsupporting

confidence: 73%

Interstitial Lung Abnormalities and Reduced Exercise Capacity

Doyle

Washko²,

Fernandez³

et al. 2012

Am J Respir Crit Care Med

116

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Rationale:The relationship between interstitial lung abnormalities (ILA) and exercise capacity has not been comprehensively evaluated. Objectives: To assess the validity of the 6-minute walk test in subjects with ILA, and to examine the association between ILA and 6-minute walk distance (6MWD). Methods: Spearman correlation coefficients were used to assess the strength of the relationships between 6MWD and relevant measures of dyspnea, health-related quality of life, and pulmonary function in a cohort of 2,416 people who smoke from the COPDGene study. Unadjusted and adjusted linear and logistic regression models were used to assess the strength of the association between ILA and 6MWD. Measurements and Main Results: In all subjects, and in those with ILA, 6MWD in COPDGene was associated with relevant clinical and physiologic measures. The mean 6MWD in COPDGene subjects with ILA was 386 m (SD, 128 m), and 82% and 19% of subjects with ILA had 6MWDs less than or equal to 500 and 250 m, respectively. ILA was associated with a reduced 6MWD in univariate (230 m; 95% confidence interval, 250 to 210; P ¼ 0.004) and multivariate models (219 m; 95% confidence interval, 233 to 25; P ¼ 0.008). Compared with subjects without ILA, subjects with ILA had an 80% and 77% increase in their odds to have a walk distance limited to less than or equal to 500 and 250 m, respectively. Although these findings were dependent on ILA subtype, they were not limited to those with COPD. Conclusions: Our study demonstrates that ILA is associated with measurable decrements in the 6MWD of people who smoke. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).Keywords: six-minute walk distance; emphysema; interstitial lung disease; subclinical; idiopathic pulmonary fibrosis Subjects with interstitial lung abnormalities (ILA) have highresolution chest computed tomography (HRCT) features characteristic of patients with idiopathic interstitial pneumonia (IIP) (1) but have not been previously diagnosed with interstitial lung disease (ILD). Although our prior findings demonstrated that people who smoke with ILA have reduced total lung capacity and emphysema (2), it is not known if these findings merely represent radiologic abnormalities or if ILA results in measureable decrements in exercise capacity.The 6-minute walk test (6MWT) is a well-described and reproducible (3) measure of exercise capacity, disease severity, and mortality in patients with cardiopulmonary disease in general (4, 5), and IIPs in particular (6-8). We hypothesized that subjects with ILA, comparable with those with clinically apparent ILD, would have reductions in the distance they could walk in 6 minutes (6MWD). To test this hypothesis, we first assessed the validity of 6MWT in all COPDGene subjects and in analyses limited to those with ILA. Next, we evaluated the association between ILA and 6MWD in 2,416 COPDGene subjects. Based on our results we evaluated the association between ILA and previously described clinically relevant 6MWD thresholds (3, 9), the role of IL...

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Section: Discussionsupporting

confidence: 73%

Interstitial Lung Abnormalities and Reduced Exercise Capacity

Doyle

Washko²,

Fernandez³

et al. 2012

Am J Respir Crit Care Med

116

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“…Recent studies have suggested that CRT is associated with favorable reverse remodeling effects on the left atrium (LA), in addition to its well-established effects on the left ventricle (LV), thereby possibly reducing the risk for the development of AT and AF in patients with HF (9,10). Despite this, data on the effect of CRT on the resolution of chronic and prevention of new atrial arrhythmias are conflicting (11)(12)(13)(14)(15), possibly because the majority of prior studies had a nonrandomized or retrospective design and comprised relatively small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Resynchronization Therapy Reduces Left Atrial Volume and the Risk of Atrial Tachyarrhythmias in MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy)

Brenyo

Link

Barsheshet

et al. 2011

Journal of the American College of Cardiology

102

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“…Published studies of the effects of CRT in patients suffering from AF are few (15)(16)(17)(18)(19). The MUSTIC (Multisite Stimulation in Cardiomyopathies) AF study, which compared the effects of single-site RV versus biventricular stimulation in patients with advanced CHF, depressed LV function, and a wide RV-paced QRS complex showed a (18) observed that the benefits conferred by CRT in candidates for CRT presenting with AF were limited to patients who had previously undergone ablation of the AV node.…”

Section: Discussionmentioning

confidence: 99%

“…The MUSTIC (Multisite Stimulation in Cardiomyopathies) AF study, which compared the effects of single-site RV versus biventricular stimulation in patients with advanced CHF, depressed LV function, and a wide RV-paced QRS complex showed a (18) observed that the benefits conferred by CRT in candidates for CRT presenting with AF were limited to patients who had previously undergone ablation of the AV node. In 74 patients with permanent AF and a slow ventricular rate, Kiès et al (19) found that CRT caused a significant decrease in LV end-systolic, LV end-diastolic, and left atrial diameter, and a significant increase in LVEF. The significant improvement in QOL, increase in distance covered during the 6-MHW test and in LVEF, and decrease in LVESV observed after 3 months of standard biventricular stimulation in our study are consistent with the results of these previous studies.…”

Section: Discussionmentioning

confidence: 99%