Benefits of Upgrading Right Ventricular to Biventricular Pacing in Heart Failure Patients with Atrial Fibrillation
Abstract
Recommendations for cardiac resynchronization therapy (CRT) in patients with atrial fibrillation are not as well-established as those for patients with sinus rhythm. The BUDAPEST-CRT Upgrade trial aimed to assess the effectiveness of CRT upgrade in heart failure patients with reduced ejection fraction and previously implanted pacemaker or implantable cardioverter defibrillator (ICD), based on their baseline rhythm.
Methods and Results
Patients with atrial fibrillation had an increased risk for heart failure hospitalization compared to those with sinus rhythm. However, the CRT-D upgrade was similarly effective in both groups, decreasing the risk of heart failure hospitalization and improving reverse remodeling compared to ICD.
Conclusion
The study concluded that in heart failure patients with atrial fibrillation and high right ventricular pacing burden, upgrading to CRT-D decreased the risk of heart failure hospitalization and improved reverse remodeling compared to ICD, similar to the benefits seen in patients with sinus rhythm.
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