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

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

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation / surgery*
  • Cardiac Resynchronization Therapy / methods*
  • Catheter Ablation / methods*
  • Combined Modality Therapy
  • Comorbidity
  • Evidence-Based Medicine
  • Heart Failure / therapy*
  • Humans
  • Pulmonary Veins / surgery*
  • Survival Rate
  • Treatment Outcome