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Updated: Mar 11, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

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Atrial Fibrillation During Cardiac Resynchronization Therapy

Mariëlle Kloosterman1, Alexander H Maass1, Michiel Rienstra1

  • 1Department of Cardiology, Thoraxcenter, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.

Heart Failure Clinics
|November 26, 2016
PubMed

Insights

Cardiac resynchronization therapy (CRT) is less effective in patients with atrial fibrillation (AF). Managing AF is crucial for optimizing CRT outcomes and ensuring successful biventricular pacing.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Landmark trials for cardiac resynchronization therapy (CRT) primarily included patients in sinus rhythm.
  • Atrial fibrillation (AF) is highly prevalent (20-40%) in patients undergoing CRT.
  • Limited data exist on CRT efficacy in patients with AF.

Purpose of the Study:

  • To review the negative impact of AF on CRT response.
  • To discuss strategies for managing patients with AF during CRT.

Main Methods:

  • Literature review focusing on studies investigating CRT in patients with AF.
  • Analysis of the effects of AF on CRT outcomes.
  • Discussion of current management approaches for AF in CRT patients.

Main Results:

  • AF significantly impairs the response to CRT.
  • The specific AF burden thresholds that reduce CRT efficacy remain unclear.
  • Successful biventricular pacing is challenging in AF patients.

Conclusions:

  • Effective management of AF is essential for improving CRT outcomes.
  • Further research is needed to define optimal AF burden thresholds for CRT response.
  • Strategies to ensure successful biventricular pacing in AF patients are critical.

Keywords:
Atrioventricular junction ablationBiventricular pacingHeart failureImplantation

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