Ventricular Resynchronization Therapy in Heart Failure Patients with Chronic Atrial Fibrillation: Is It Worthwhile ?

摘要

Ventricular resynchronization therapy (VRT) through biventricular pacing has recently been validated as a new treatment [1] for refractory heart failure in patients with chronic left ventricular systolic dysfunction and signs of discoor-dinated ventricular activation and contraction. Following positive results from several acute haemodynamic studies with temporary pacing [2-8] and those of two pilot studies with permanent pacing [10-12], controlled studies [1, 13] showed that atriobiventricular pacing with individually optimized AV synchrony significantly improved symptoms, exercise tolerance and quality of life in patients with severe heart failure (NYHA Classes III-IV) and stable sinus rhythm, without classical indication for permanent cardiac pacing. In addition, the number of hospitalizations for decompensated heart failure decreased significantly.