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It is a marker of impaired CRT response mainly mediated by the reduction of effectively captured biventricular paced beats (BiVp). There are no randomized trials comparing strategies to maintain high BiVp percentage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the efficacy of rhythm vs rate control strategies in CRT recipients with long-standing persistent AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a randomized trial including CRT recipients with persistent AF resulting in low BiVp%. All patients received amiodarone, the rhythm control group received external electrical cardioversion (EC), and the rate control group received atrioventricular node ablation, if needed. The primary end-point was 12-month BiVp% (NCT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      43 patients were included in the analysis. The mean age was 68.4 (SD:\u2009\u00b1\u20098.3) years and the mean BiVp% 82.4%\u2009\u00b1\u20099.7%. AF lasted 25\u2009\u00b1\u200919 months. The mean baseline left ventricular ejection fraction (LVEF), left atrium area, and the maximal oxygen uptake (VO2max) were: 30\u2009\u00b1\u20098%, 33\u2009\u00b1\u20097 cm\n                      <jats:sup>2<\/jats:sup>\n                      , and 14\u2009\u00b1\u20095 mL\/(kg*min), respectively. The EC success rate was 58%. 38% patients remained in sinus rhythm (SR) after 12 months. BiVp% increased similarly in both arms reaching 99% [95% CI 97.3\u201399.8] and 98% [94.0\u201399.0],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.14 in rhythm and rate control groups, respectively. LVEF raised significantly only in the rhythm control group (\u0394LVEF 4.1 (\u00b1\u20097.3),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090,018) which was driven by the patients who maintained SR. No differences in VO2max, QoL, clinical and safety end-points were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite comparable BiVp% in both groups, only restoration of SR led to improved left ventricular ejection fraction in CRT patients with long-standing AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>NCT01850277 registered on 22\/04\/2013.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-024-02541-z","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T05:02:19Z","timestamp":1728536539000},"page":"566-575","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Rhythm and rate control strategies in patients with long-standing persistent atrial fibrillation treated with cardiac resynchronization: the results of the randomized Pilot-CRAfT study"],"prefix":"10.1007","volume":"115","clinical-trial-number":[{"clinical-trial-number":"nct01850277","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9535-0059","authenticated-orcid":false,"given":"Jan B.","family":"Ciszewski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mateusz","family":"Tajstra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilona","family":"Kowalik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksander","family":"Maci\u0105g","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Chwyczko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Jankowska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edyta","family":"Smolis-B\u0105k","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bohdan","family":"Firek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dariusz","family":"Zaj\u0105c","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaros\u0142aw","family":"Karwowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Szwed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariusz","family":"Pytkowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariusz","family":"G\u0105sior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Sterli\u0144ski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"issue":"46","key":"2541_CR1","doi-asserted-by":"publisher","first-page":"3547","DOI":"10.1093\/eurheartj\/eht290","volume":"34","author":"JG Cleland","year":"2013","unstructured":"Cleland JG, Abraham WT, Linde C, Gold MR, Young JB, Claude Daubert J et al (2013) An individual patient meta-analysis of five randomized trials assessing the effects of cardiac resynchronization therapy on morbidity and mortality in patients with symptomatic heart failure. 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DZ\u2014lectures\u2019 fees from Biotronik and Medtronic. JC\u2014consultant fees from Medtronic, lectures fees from Abbott, educational\/fellowship and travel grants from Abbott and Bioscience Webster. MS\u2014consultant fees from Abbott, Biotronik, HammerMed, Medtronic, Zoll, study grants from Biotronik and Medtronic. MT\u2014consulting board fees from Medtronic, proctoring fees from Abbott, lectures\u2019 fees from Boston Scientific and Biotronik. The other authors declare no conflicts to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}