OUR EXPERIENCES WITH CRT IN CHF PATIENTS (SINUS RHYTHM COMPARED TO ATRIAL FIBRILLATION)

Aim: The aim of the study was to evalute the state of the patients (pts.) with congestive heart failure (CHF) one year after receiving cardiac resynchronisation therapy (CRT). We compared pts. with sinus rhythm (SR) and atrial fibrillation (AF).
Study group and methods:  We determined the quality of life (QOL), mortality, left ventricular ejection fraction (LVEF), mitral regurgitation (MiReg.), tricuspid regurgitation (TriReg.) in pts. before receiving CRT and in 12th month after receiving CRT at the Cardiology Clinic of The University Hospital Brno within the years 2003-2005. CRT devices received 74 pts. with CHF, the mean age was 67 ± 8 years, male pts. 71,6%. The mean follow up of the pts. was 23 ± 14 months. 9 pts. (12,2%) were in AF, 65 pts. were in SR, of whom permanently in SR retained 59 pts. (79,7%) and AF developed in 6 pts. (8,1%) after receiving CRT.
Results: One-year mortality of SR pts. was 11,9% (7 pts.), of AF pts. was 11,1% (1pt.) and pts. with newly developed AF was 16,67% (1pt.). The QOL in 12th month was significantly better in SR pts. vs. AF pts. (p<0,001). There was a significant improvement of LVEF (p<0,02), MiReg.(p<0,07) in 12th month after receiving CRT, no significant differences were found in TriReg. No significant differences were found in both groups of AF pts. in any of followed parameters in 12th month compared to the initial state. 
Conclusions: The benefit from the CRT in CHF pts. was confirmed by one-year follow up. No significant differences were found in one-year mortality between SR pts. and permanent AF pts. (p=NS) nor between SR pts. and pts. with newly developed AF (p=NS). We found significantly improved QOL, LVEF, MiReg. in SR pts. in 12th month after receiving CRT. No significant differences in QOL nor echoparameters were found in AF pts.in 12th month after receiving CRT.