IF SYNUS RHYTHM RESTORATION IMPACTS EFFICIENCY OF CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS WITH SEVERE CARDIAC INSUFFICIENCY AND CONSTANT ATRIAL FIBBRILATION

We analyzed influence of sinus rhythm restoration in patients with severe heart insufficiency and permanent atrial fibrillation on efficiency of cardiac resynchronization therapy. In the study we included 150 patients (76 female patients), mean age was 47,7±10,9 years, with chronic cardiac insufficiency III functional class (FC) according to NYHA with main diagnosis dilated cardiomyopathy (DCMP) and registered stable form of atrial fibrillation (AF). Complex QRS width varied from 146 ms to 240 ms (mean 183±32 ms), ejection fraction (EF) of left ventricle was 30,1±3,8%, EDV was 272,4±49,8 ml. six-minute distance was 247,8±57,3 m. Optimal medical therapy for CCI was ineffective from three to six months. All patients had CRT devices. Control assessment was performed in 36 months. Analysis of CRT results, for 36 months, demonstrated improved HR in 115 (76,7%). In this group for 3-year follow up period EF changed from 29,0±3,8% to 42,5±4,2% (р<0,0001), and increase rate was 18%, EDV decreased from 215,9±58,1 ml to 177,1±26,6 ml (p<0,0005), to 48 ml in general. In 35 (23,3%) patients during 36 months AF preserved, and in this group for 3 years, LV EF increased from 29,0±3,8% to 38,7±2,1%, and increase rate was 9%, EDV decreased from 215,9±58,1 ml to 200,7±39,1 ml.(p<0,0005), to 15ml in general. Thus, in patients with DCMP and severe cardiac insufficiency SR is a serious task, as it enables to achieve stable increase of EF and reduce EDV during all period of CRT.

cardiac resynchronization therapy, atrial fibrillation, dilated cardiomyopathy

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