التفاصيل البيبلوغرافية
| العنوان: |
Abstract 12823: Short- and Long-Term Association of Atrial Fibrillation Burden With Heart Failure Events in Patients With Cardiac Resynchronization Therapy Devices. |
| المؤلفون: |
Tanawuttiwat, Tanyanan1 (AUTHOR), Lande, Jeff2 (AUTHOR), Smeets, Pascal3 (AUTHOR), Shanahan, Liesa4 (AUTHOR), Gerritse, Bart5 (AUTHOR), Nazarian, Saman6 (AUTHOR), Guallar, Eliseo7 (AUTHOR), Cheng, Alan2 (AUTHOR) |
| المصدر: |
Circulation. 2018 Supplement, Vol. 138, pA12823-A12823. 1p. |
| مصطلحات موضوعية: |
*HEART failure patients, *VENTRICULAR fibrillation, *ATRIAL fibrillation, *CARDIAC patients, *CARDIAC pacing, *HEART failure, *HEART assist devices |
| مستخلص: |
Introduction: Atrial fibrillation (AF) and heart failure (HF) often coexist but little is known on how AF burden associates with subsequent episodes of HF. Hypothesis: The aim of this study is to quantitatively assess the short- and long-term association of AF burden with subsequent episodes of HF events in cardiac resynchronization therapy (CRT) patients with reduced ejection fraction. Methods: A cohort study of CRT patients enrolled in the Medtronic Product Surveillance Registry with at least 90 days of Cardiac Compass data were included in the study. Time-dependent Cox regression was used to evaluate the association of short- and long-term AF burden. Short-term AF burden was defined as the change in the daily AF burden compared to the moving AF burden average since the time of implant. Long-term AF burden was defined as the overall average AF burden since the time of implant. Each patient with HF was matched to 2 control patients without HF event based on age, gender, year of implant and CRT defibrillation capability. Other covariates included intrathoracic impedance and ventricular pacing percentage. Results: Among 542 patients, 177 developed HF over an average follow-up of 24 ± 11 months. Short-term AF burdenwas associated with subsequent HF events (adjusted hazard ratio [aHR] for an increase in 1 hour/day of AF burden 1.05, 95% confidence interval [CI] 1.03-1.08, p-value <0.01). In contrast, there was no association between long-term AF burden and subsequent HF events (aHR for an increase in 1 hour/day of AF burden 1.01, 95% CI 0.99-1.03, p-value 0.28). The reduction of intrathoracic impedance was associated with subsequent HF events (aHR 0.85 for an increase in an ohm of intrathoracic impedance, 95% CI 0.83-0.86, p-value = <0.01). Conclusion: Every hour of increased AF burden is associated with a 5% increased risk of HF over the subsequent week (short-term), independent of intrathoracic impedance. These findings quantitate the association of AF burden with HF events and are consistent with a causal effect AF on HF episodes due to the temporal direction of the association. [ABSTRACT FROM AUTHOR] |
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