Plummer CJ, et al. - Researchers ascertained if effective cardiac resynchronization therapy delivered during atrial fibrillation with a novel algorithm (eCRTAF) raised the amount of effective cardiac resynchronization therapy (CRT) delivered during atrial fibrillation (AF) when compared to a currently available rate regularization algorithm. A substantial rise was reported in % effective CRT (%eCRT) pacing and % of ventricular pacing (%Vp) during AF with a small increase in mean heart rate (HR) via eCRTAF in CRT patients with a history of AF. This algorithm could serve as a novel non-invasive method of notably increasing effective CRT delivery during AF, thereby improving CRT response.

Methods

• This study recruited patients previously implanted with a CRT-D device, with a history of AF and intact AV conduction.
• They received up to 4 weeks of control (Conducted AF Response) and up to 4 weeks of eCRTAF in a randomized sequence.
• Researchers recorded % effective CRT (eCRT) pacing, which excluded beats without LV capture, %Vp and mean heart rate (HR), during AF and sinus rhythm.

Results

• The yielded data displayed that eCRTAF algorithm led to a markedly higher %eCRT during AF than Control (87.8±7.8 % vs 80.8±14.3%, p < 0.001) and %Vp during AF than Control (90.0±5.9% vs 83.2± 11.9%, p < 0.001) with a small, yet statistically prominent rise in the mean HR of 2.5 bpm (79.5±9.7 vs 77.0± 9.9 bpm, p < 0.001).