{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:12:57Z","timestamp":1790345577553,"version":"4.1.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BUDAPEST CRT Upgrade"},{"DOI":"10.13039\/501100002332","name":"Semmelweis University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002332","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008497","name":"Boston Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Heart Program","award":["NVKP_16\u20131\u20132016-0017"],"award-info":[{"award-number":["NVKP_16\u20131\u20132016-0017"]}]},{"name":"National Research Development and Innovation Fund of Hungary"},{"name":"NVKP_16 funding scheme","award":["RRF-2.3.1-21-2022-00003"],"award-info":[{"award-number":["RRF-2.3.1-21-2022-00003"]}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bolyai Janos Research Scholarship"},{"DOI":"10.13039\/501100003825","name":"Hungarian Academy of Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003825","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Recommendations on cardiac resynchronization therapy (CRT) in patients with atrial fibrillation or flutter (AF) are based on less robust evidence than those in sinus rhythm (SR). We aimed to assess the efficacy of CRT upgrade in the BUDAPEST-CRT Upgrade trial population by their baseline rhythm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Heart failure patients with reduced ejection fraction (HFrEF) and previously implanted pacemaker (PM) or implantable cardioverter defibrillator (ICD) and \u226520% right ventricular (RV) pacing burden were randomized to CRT with defibrillator (CRT-D) upgrade (n = 215) or ICD (n = 145). Primary [HF hospitalization (HFH), all-cause mortality, or &amp;lt;15% reduction of left ventricular end-systolic volume] and secondary outcomes were investigated. At enrolment, 131 (36%) patients had AF, who had an increased risk for HFH as compared with those with SR [adjusted hazard ratio (aHR) 2.99; 95% confidence interval (CI) 1.26\u20137.13; P = 0.013]. The effect of CRT-D upgrade was similar in patients with AF as in those with SR [AF adjusted odds ratio (aOR) 0.06; 95% CI 0.02\u20130.17; P &amp;lt; 0.001; SR aOR 0.13; 95% CI 0.07\u20130.27; P &amp;lt; 0.001; interaction P = 0.29] during the mean follow-up time of 12.4 months. Also, it decreased the risk of HFH or all-cause mortality (aHR 0.33; 95% CI 0.16\u20130.70; P = 0.003; interaction P = 0.17) and improved the echocardiographic response (left ventricular end-diastolic volume difference \u221249.21 mL; 95% CI \u221269.10 to \u221229.32; P &amp;lt; 0.001; interaction P = 0.21).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In HFrEF patients with AF and PM\/ICD with high RV pacing burden, CRT-D upgrade decreased the risk of HFH and improved reverse remodelling when compared with ICD, similar to that seen in patients in SR.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euae179","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T08:14:47Z","timestamp":1720512887000},"source":"Crossref","is-referenced-by-count":16,"title":["Benefits of upgrading right ventricular to biventricular pacing in heart failure patients with atrial fibrillation"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6514-0723","authenticated-orcid":false,"given":"B\u00e9la","family":"Merkely","sequence":"first","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9674-2540","authenticated-orcid":false,"given":"Robert","family":"Hatala","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, National Institute of Cardiovascular Diseases, Slovak Medical University , Bratislava , Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6817-1437","authenticated-orcid":false,"given":"Eperke","family":"Merkel","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7250-7888","authenticated-orcid":false,"given":"M\u00e1ty\u00e1s","family":"Szigeti","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3889-3794","authenticated-orcid":false,"given":"Bogl\u00e1rka","family":"Veres","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8449-0638","authenticated-orcid":false,"given":"Alexandra","family":"F\u00e1bi\u00e1n","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8209-990X","authenticated-orcid":false,"given":"Istv\u00e1n","family":"Osztheimer","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6802-6360","authenticated-orcid":false,"given":"L\u00e1szl\u00f3","family":"Gell\u00e9r","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1878-9286","authenticated-orcid":false,"given":"Michal","family":"Sasov","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, National Institute of Cardiovascular Diseases, Slovak Medical University , Bratislava , Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6335-0273","authenticated-orcid":false,"given":"Jerzy K","family":"Wranicz","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Medical University of Lodz , Lodz , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5033-117X","authenticated-orcid":false,"given":"Csaba","family":"F\u00f6ldesi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gottsegen National Cardiovascular Center , Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1286-6576","authenticated-orcid":false,"given":"G\u00e1bor","family":"Duray","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest\u2014Military Hospital , Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-9597","authenticated-orcid":false,"given":"Scott D","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0016-289X","authenticated-orcid":false,"given":"Valentina","family":"Kutyifa","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"},{"name":"Clinical Cardiovascular Research Center, University of Rochester , Rochester, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2320-6434","authenticated-orcid":false,"given":"Attila","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6647-2623","authenticated-orcid":false,"given":"Annam\u00e1ria","family":"Kosztin","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Varosmajor 68, H-1122 Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"2024073112221101000_euae179-B1","doi-asserted-by":"crossref","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","article-title":"Heart disease and stroke statistics-2020 update: a report from the American Heart Association","volume":"141","author":"Virani","year":"2020","journal-title":"Circulation"},{"key":"2024073112221101000_euae179-B2","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1056\/NEJMoa013040","article-title":"Ventricular pacing or dual-chamber pacing for sinus-node dysfunction","volume":"346","author":"Lamas","year":"2002","journal-title":"N Engl J Med"},{"key":"2024073112221101000_euae179-B3","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.1001\/jama.288.24.3115","article-title":"Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the Dual Chamber and VVI Implantable Defibrillator (DAVID) trial","volume":"288","author":"Wilkoff","year":"2002","journal-title":"JAMA"},{"key":"2024073112221101000_euae179-B4","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1016\/j.hrthm.2016.09.027","article-title":"Incidence and predictors of right ventricular pacing-induced cardiomyopathy in patients with complete atrioventricular block and preserved left ventricular systolic function","volume":"13","author":"Kiehl","year":"2016","journal-title":"Heart Rhythm"},{"key":"2024073112221101000_euae179-B5","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"2021 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: developed by the task force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) with the special contribution of the European Heart Rhythm Association (EHRA)","volume":"42","author":"Glikson","year":"2021","journal-title":"Eur Heart J"},{"key":"2024073112221101000_euae179-B6","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1056\/NEJMoa0906431","article-title":"Cardiac-resynchronization therapy for the prevention of heart-failure events","volume":"361","author":"Moss","year":"2009","journal-title":"N Engl J Med"},{"key":"2024073112221101000_euae179-B7","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1056\/NEJMoa1009540","article-title":"Cardiac-resynchronization therapy for mild-to-moderate heart failure","volume":"363","author":"Tang","year":"2010","journal-title":"N Engl J Med"},{"key":"2024073112221101000_euae179-B8","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1056\/NEJMoa050496","article-title":"The effect of cardiac resynchronization on morbidity and mortality in heart failure","volume":"352","author":"Cleland","year":"2005","journal-title":"N Engl J Med"},{"key":"2024073112221101000_euae179-B9","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1016\/j.jacc.2008.08.027","article-title":"Randomized trial of cardiac resynchronization in mildly symptomatic heart failure patients and in asymptomatic patients with left ventricular dysfunction and previous heart failure symptoms","volume":"52","author":"Linde","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2024073112221101000_euae179-B10","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1161\/CIRCULATIONAHA.108.793273","article-title":"Cardiac resynchronization therapy reduces the risk of hospitalizations in patients with advanced heart failure","volume":"119","author":"Anand","year":"2009","journal-title":"Circulation"},{"key":"2024073112221101000_euae179-B11","doi-asserted-by":"crossref","first-page":"4259","DOI":"10.1093\/eurheartj\/ehad591","article-title":"Upgrade of right ventricular pacing to cardiac resynchronisation therapy in heart failure: a randomised trial","volume":"44","author":"Merkely","year":"2023","journal-title":"Eur Heart J"},{"key":"2024073112221101000_euae179-B12","first-page":"1549","article-title":"Rationale and design of the BUDAPEST-CRT upgrade study: a prospective, randomized, multicentre clinical trial","volume":"19","author":"Merkely","year":"2017","journal-title":"Europace"},{"key":"2024073112221101000_euae179-B13","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.1002\/ejhf.2609","article-title":"Baseline clinical characteristics of heart failure patients with reduced ejection fraction enrolled in the BUDAPEST-CRT upgrade trial","volume":"24","author":"Merkely","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"2024073112221101000_euae179-B14","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2024073112221101000_euae179-B15","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.jchf.2013.06.003","article-title":"Cardiac resynchronization therapy in patients with atrial fibrillation: the CERTIFY study (Cardiac Resynchronization Therapy in Atrial Fibrillation Patients Multinational Registry)","volume":"1","author":"Gasparini","year":"2013","journal-title":"JACC Heart Fail"},{"key":"2024073112221101000_euae179-B16","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1002\/clc.22312","article-title":"Effects of atrioventricular nodal ablation on permanent atrial fibrillation patients with cardiac resynchronization therapy: a systematic review and meta-analysis","volume":"37","author":"Yin","year":"2014","journal-title":"Clin Cardiol"},{"key":"2024073112221101000_euae179-B17","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1161\/CIRCHEARTFAILURE.112.968867","article-title":"Cardiac resynchronization therapy in patients with permanent atrial fibrillation: results from the Resynchronization for Ambulatory Heart Failure Trial (RAFT)","volume":"5","author":"Healey","year":"2012","journal-title":"Circ Heart Fail"},{"key":"2024073112221101000_euae179-B18","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1111\/jce.16022","article-title":"Cardiac resynchronization therapy in patients with a prior history of atrial fibrillation: insights from four major clinical trials","volume":"34","author":"Dalgaard","year":"2023","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2024073112221101000_euae179-B19","doi-asserted-by":"crossref","first-page":"euae085","DOI":"10.1093\/europace\/euae085","article-title":"A multicenter, cohort study of catheter ablation for persistent atrial fibrillation with\/without atrial fibrillation termination (the termination-atrial fibrillation study)","volume":"26","author":"Li","year":"2024","journal-title":"Europace"},{"key":"2024073112221101000_euae179-B20","doi-asserted-by":"crossref","first-page":"euae043","DOI":"10.1093\/europace\/euae043","article-title":"2024 European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart Rhythm Society\/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"26","author":"Tzeis","year":"2024","journal-title":"Europace"},{"key":"2024073112221101000_euae179-B21","doi-asserted-by":"crossref","first-page":"euae070","DOI":"10.1093\/europace\/euae070","article-title":"Longer and better lives for patients with atrial fibrillation: the 9th AFNET\/EHRA consensus conference","volume":"26","author":"Linz","year":"2024","journal-title":"Europace"},{"key":"2024073112221101000_euae179-B22","doi-asserted-by":"crossref","first-page":"euad226","DOI":"10.1093\/europace\/euad226","article-title":"Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal","volume":"25","author":"Lip","year":"2023","journal-title":"Europace"},{"key":"2024073112221101000_euae179-B23","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1093\/europace\/euaa065","article-title":"European heart Rhythm Association (EHRA)\/Heart Rhythm Society (HRS)\/Asia Pacific Heart Rhythm Society (APHRS)\/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population","volume":"22","author":"Nielsen","year":"2020","journal-title":"Europace"}],"container-title":["Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euae179\/58478471\/euae179.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/26\/7\/euae179\/58616211\/euae179.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/26\/7\/euae179\/58616211\/euae179.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T02:00:18Z","timestamp":1722477618000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/doi\/10.1093\/europace\/euae179\/7709529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7,2]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euae179","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,7]]},"published":{"date-parts":[[2024,7]]},"article-number":"euae179"}}