Abstract
Abstract Category: 26. Clinical Electrophysiology—Supraventricular ArrhythmiasSession-Poster Board Number: 1161-402Authors: David A. Cesario, Brian Powell, Michael Cao, Leslie Saxon, John Day, Nicholas Wold, Keck School of Medicine at USC, Los Angeles, CABackground: Atrial ibrillation (AF) is a common co-morbidity in patients (pts) receiving Cardiac Resynchronization Therapy deibrillators (CRT-D). The effect of AF on pt outcomes in CRT-D remains incompletely understood. We sought to evaluate outcomes in CRT-D pts according to AF burden, using the Boston Scientiic LATITUDE remote monitoring system ALTITUDE database.Methods: The AF burden was determined in the irst year of implant using atrial tachycardia response (ATR) episode length and pacing mode. Pts were grouped as having Persistent AF (ATR > 7 days or programmed VVI/R, DDI/R mode), Paroxysmal AF 1-7 days (1 day < ATR < 7 days), Paroxysmal AF < 1 day (1 minute < ATR < 1 day), or no AF (all others). Survival after the irst year was evaluated between groups using Cox Proportional Hazard models adjusting for age, gender, percent CRT pacing and shock therapy in year 1.Results: The 23,743 pts studied consisted of pts with no AF (N=13,331, 56%), Persistent AF (N=4,711, 20%), Paroxysmal AF 1-7 days (N=896, 4%), and Paroxysmal AF < 1 day (N=4,805, 20%). Pts with AF were more likely to be male (78% vs 68%), older (72 11 vs 69 11), have lower CRT pacing (median 97% vs 99%) and more likely to have a shock episode within 1 year post implant (13% vs 6.4%), all p<.001. When compared to no AF, all 3 AF groups exhibited decreased survival (igure).Conclusion: In a large cohort of CRT recipients, AF was identiied as an independent marker for decreased survival. This observation was signiicant even for a very low burden of AF.
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