The Deleterious Effect of Atrial Fibrillation and Its Association with Mortality in Non-Responders to Cardiac Resynchronization Therapy

Abstract

The well known of the mechanism for atrial fibrillation (AF) accounts for the failure and relative success of the different therapeutic maneuvers in the management of AF. Despite medical improvements made in recent years, patients with heart failure (HF) are at increased risk of developing AF [1-3]. AF is known to worsen the clinical course of HF through multiple mechanisms including rapid ventricular response, irregularity of ventricular rhythm, loss of organized atrial contribution to cardiac output, and in some cases, tachycardiainduced cardiomyopathy. The prevalence of AF, in patients with HF, increases with the severity of the disease reaching up to 50% in advanced cases. In these patients with HF, AF is an independent predictor of morbidity and mortality increasing the risk of death and hospitalization in 76% [4][5][6][7].

Correlation among P wave dispersion and cardiac arrhythmias and alterations of the conduction system in patients with arterial hypertension from the Hospital de Clinicas, Asunción, Paraguay

“…Hemos reportado previamente que los pacientes con una predisposición para desarrollar FA tienen una incidencia significativamente mayor de electrogramas auriculares endocárdicos anormalmente prolongados (37)(38)(39)(40) y fraccionados . En el momento del mapeo endocárdico auricular por catéter durante el ritmo sinusal, hemos reportado anteriormente que un electrograma auricular anormalmente prolongado y fraccionado puede reflejar una actividad eléctrica local no homogénea relacionada con una conducción anisotrópica no uniforme a través del músculo auricular enfermo.…”