467 Differential effects on systolic and diastolic function after temporary suspension of long-term cardiac resynchronization therapy

Abstract

Correlation coefficient (r) for DTI DI and 3D 6 DI was 0.7898, p<0.0001; and 0.7271, p<0.0001, for 3D 12 DI. Linear regression equation for DTI DI (y) and 3D 6 DI (x), was: y=0.3230+0.5976 x, p<0.0001; linear regression equation for DTI DI ( y) and 3D 12 DI (x), was: y=0.6575+0.1749 x, p<0.0001. Conclusions: In this small series we observed good correlation between 3D echocardiography and DTI LV dyssynchrony assessment. Further studies should be undertaken with larger series of patients with increased ECG du- ration and decreased LVEF. Introduction: Cardiac resynchronization therapy (CRT) has shown to re- duce morbidity and mortality in selected patients with heart failure, and to promote left ventricular and atrial positive remodelling in patients with sinus rhythm. However there is few information about the impact of CRT in pa- tients with atrial fibrillation. Objective: To study left ventricular and atrial remodelling in patients with atrial fibrillation (AF) treated with CRT. Material and methods: Out of 170 patients treated with CRT, 26 (15%) pa- tients presented with AF, of which 10 patients with paroxysmal AF, 6 with persistent AF and 10 with permanent AF (5 patients with previous chronic right ventricular pacing). 24 patients were male, the mean age was 69±9 years, 10 patients had coronary artery disease and the mean ejection frac- tion was 31±10%, 21 patients had an ICD and 5 patients had pacema- kers. The mean time of the follow up was 17.14±12.6 months. An echocardio- gram (Philips Sonos® 5500) was performed to assess the left ventricular and atrial volume (Simpson method) and left atrial volume with the area- length method (area 4C x area 2C x 0.85/L). Results: Shown in the table. The left ventricular function improved in the three groups of patients. The left atrial volume reduction was apreciated in all groups, but patients with persitent and permanent AF experimeted sig- nificative reductions. Conclusion: Patients with AF treated with CRT present positive left ventricu- lar remodelling with left ventricular function improvement and decrease in left atrial volume.