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Cardiac resynchronisation therapy response predicts occurrence of atrial fibrillation in non-ischaemic dilated cardiomyopathy

Authors

  • S. L. D’Ascia,

    1. Division of Cardiology, Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, “Federico II” University, Naples, Italy
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  • C. D’Ascia,

    1. Division of Cardiology, Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, “Federico II” University, Naples, Italy
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  • V. Marino,

    1. Division of Cardiology, Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, “Federico II” University, Naples, Italy
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  • A. Lombardi,

    1. Faculty of Mathematical, Physical and Natural Sciences, University of Salento, Lecce, Italy
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  • R. Santulli,

    1. Department of Mathematics, University of Salerno, Fisciano (SA), Italy
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  • M. Chiariello,

    1. Division of Cardiology, Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, “Federico II” University, Naples, Italy
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    • Disclosures None.

  • G. Santulli

    1. Division of Cardiology, Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, “Federico II” University, Naples, Italy
    2. College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
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  • Since this paper was submitted this author has died.

Dr Gaetano Santulli,
Division of Cardiology, Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, “Federico II” University, Naples, Italy
Tel/Fax: +39 081 746 3075
Email: gaetano.santulli@unina.it

Summary

Aim:  The aim of this study was to determine whether or not cardiac resynchronization therapy (CRT) has a favourable effect on the incidence of new-onset atrial fibrillation (AF) in a homogeneous population of patients with non-ischaemic idiopathic-dilated cardiomyopathy and severe heart failure.

Methods:  We designed a single-centre prospective study and enrolled 58 patients AF naïve when received CRT. After 1 year of follow-up our population was subdivided into responders (72.4%) and non-responders (27.6%), so as to compare the incidence of AF after 1, 2 and 3 years of follow-up in these two groups.

Results:  Already after 1 year, there was a significant (p < 0.05) difference in new-onset AF in non-responder patients with respect to responders (18.2% vs. 3.3%). These data were confirmed at 2 years (33.3% vs. 12.2%) and 3 years (50.0% vs. 15.0%) follow-up. In particular, 3 years after device implantation non-responders had an increased risk to develop new-onset AF (OR = 5.67).

Conclusions:  This is the first study analysing long-term effects of CRT in a homogeneous population of patients with non-ischaemic dilated cardiomyopathy, indicating the favourable role of this non-pharmacological therapy on the prevention of AF.

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