How to Improve Cardiac Resynchronization Therapy Benefit in Atrial Fibrillation Patients: Pulmonary Vein Isolation (and Beyond)

doi:10.1016/j.hfc.2016.07.016

Review

. 2017 Jan;13(1):199-208.

doi: 10.1016/j.hfc.2016.07.016.

How to Improve Cardiac Resynchronization Therapy Benefit in Atrial Fibrillation Patients: Pulmonary Vein Isolation (and Beyond)

Carola Gianni¹, Luigi Di Biase², Sanghamitra Mohanty³, Yalçın Gökoğlan³, Mahmut Fatih Güneş³, Amin Al-Ahmad³, J David Burkhardt³, Andrea Natale⁴

Affiliations

¹ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
² Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA; Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Biomedical Engineering, University of Texas, Austin, TX, USA; Department of Cardiology, University of Foggia, Foggia, Italy.
³ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA.
⁴ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA; MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Division of Cardiology, Stanford University, Stanford, CA, USA; Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, CA, USA; Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA, USA; Dell Medical School, University of Texas, Austin, TX, USA. Electronic address: dr.natale@gmail.com.

PMID: 27886924
DOI: 10.1016/j.hfc.2016.07.016

Review

How to Improve Cardiac Resynchronization Therapy Benefit in Atrial Fibrillation Patients: Pulmonary Vein Isolation (and Beyond)

Carola Gianni et al. Heart Fail Clin. 2017 Jan.

. 2017 Jan;13(1):199-208.

doi: 10.1016/j.hfc.2016.07.016.

Authors

Carola Gianni¹, Luigi Di Biase², Sanghamitra Mohanty³, Yalçın Gökoğlan³, Mahmut Fatih Güneş³, Amin Al-Ahmad³, J David Burkhardt³, Andrea Natale⁴

Affiliations

¹ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
² Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA; Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Biomedical Engineering, University of Texas, Austin, TX, USA; Department of Cardiology, University of Foggia, Foggia, Italy.
³ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA.
⁴ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA; MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Division of Cardiology, Stanford University, Stanford, CA, USA; Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, CA, USA; Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA, USA; Dell Medical School, University of Texas, Austin, TX, USA. Electronic address: dr.natale@gmail.com.

PMID: 27886924
DOI: 10.1016/j.hfc.2016.07.016

Abstract

Although cardiac resynchronization therapy (CRT) is an important treatment of symptomatic heart failure patients in sinus rhythm with low left ventricular ejection fraction and ventricular dyssynchrony, its role is not well defined in patients with atrial fibrillation (AF). CRT is not as effective in patients with AF because of inadequate biventricular capture and loss of atrioventricular synchrony. Both can be addressed with catheter ablation of AF. It is still unclear if these therapies offer additive benefits in patients with ventricular dyssynchrony. This article discusses the role and techniques of catheter ablation of AF in patients with heart failure, and its application in CRT recipients.

Keywords: Atrial fibrillation; Cardiac resynchronization therapy; Catheter ablation; Heart failure; Pulmonary vein ablation; Triggers.

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How to Improve Cardiac Resynchronization Therapy Benefit in Atrial Fibrillation Patients: Pulmonary Vein Isolation (and Beyond)

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How to Improve Cardiac Resynchronization Therapy Benefit in Atrial Fibrillation Patients: Pulmonary Vein Isolation (and Beyond)

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