title: Is cardiac resynchronization therapy an antiarrhythmic therapy for atrial fibrillation? A systematic review and meta-analysis.
abstract: The impact of cardiac resynchronization therapy (CRT) on atrial fibrillation (AF) burden is poorly characterized. To assess the influence of CRT on AF, we performed a systematic literature search in MEDLINE using the MeSH headings "cardiac resynchronization therapy" or "cardiac pacing, artificial" and "atrial fibrillation." Selected studies were peer-reviewed and written in English. Most studies enrolled patients meeting traditional CRT criteria. Ten observational studies and two secondary analyses of clinical trials were identified. Although ten studies suggest that CRT favorably impacts AF, one secondary analysis of a clinical trial showed no effect of CRT on new-onset AF. In a meta-analysis of three studies examining the effect of CRT on persistent or permanent AF, the combined rate of conversion from persistent or permanent AF to sinus rhythm was 0.107 (95 % confidence interval 0.069-0.163). Prospective studies, particularly among patients not meeting traditional CRT criteria, are needed.
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, PO Box 17969, Durham, NC 27715, USA. p.hess@duke.edu
authors.forename: Paul L
authors.initials: PL
authors.lastname: Hess
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Jackson
authors.forename: Vic
authors.initials: V
authors.lastname: Hasselblad
authors.forename: Sana M
authors.initials: SM
authors.lastname: Al-Khatib
mesh_terms: D001281:Atrial Fibrillation / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy; D006801:Humans; D016896:Treatment Outcome