{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:56:52Z","timestamp":1768784212582,"version":"3.49.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>We classified patients\u2019 atrial fibrillation (AF), assessed its impact on biventricular pacing (BIVP%), and determined whether AF classification or BIVP% independently correlate with mortality in cardiac resynchronization therapy defibrillator patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Cardiac resynchronization therapy defibrillator patients were classified as permanent (daily mean AF burden \u226523 hours), persistent (\u22657 consecutive days of AF \u226523 hours\/d), paroxysmal (\u22651 day with AF \u22656 hours), or no\/little AF (all others) using device-detected AF during the 6 months postimplant. We evaluated subsequent all-cause mortality using a multivariable Cox proportional hazard regression. Among 54\u2009019 patients (age, 70\u00b111 years; 73% male; follow-up, 2.3\u00b11.2 years), 8% of patients each had permanent (N=4449), persistent (N=4237), and paroxysmal AF (N=4219). A high proportion of patients with permanent (69%) and persistent (62%) AF did not achieve high BIVP (&gt;98%). Relative to no\/little AF, patients with AF had increased mortality after adjusting for age, sex, BIVP, and shocks (permanent: hazard ratio=1.28 [1.19\u20131.38];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; persistent: hazard ratio=1.51 [1.41\u20131.61];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Relative to patients with BIVP &gt;98%, patients with reduced BIVP had increased mortality after adjusting for age, sex, AF, and shocks (90%\u201398%: hazard ratio=1.20 [1.15\u20131.26];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; &lt;90%: hazard ratio=1.32 [1.23\u20131.41];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). High BIVP% was associated with the greatest mortality improvement in permanent AF among the AF classifications.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>High BIVP% was not achieved in two thirds of 8686 patients with persistent or permanent AF, and these patients had an increased risk of death. A shift toward more aggressive rate control and more pacing may be necessary in patients with AF to maximize the benefits of cardiac resynchronization therapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.113.001212","type":"journal-article","created":{"date-parts":[[2014,5,19]],"date-time":"2014-05-19T00:08:00Z","timestamp":1400458080000},"page":"370-376","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":72,"title":["The Epidemic of Inadequate Biventricular Pacing in Patients With Persistent or Permanent Atrial Fibrillation and Its Association With Mortality"],"prefix":"10.1161","volume":"7","author":[{"given":"Kevin T.","family":"Ousdigian","sequence":"first","affiliation":[{"name":"From the Medtronic, Inc, Minneapolis, MN (K.T.O., J.L.K., P.D.Z.); Centennial Heart, Nashville, TN (P.P.B.); Scripps Clinic, San Diego, CA (J.T.H.); and Cleveland Clinic Foundation, OH (B.L.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. Peter","family":"Borek","sequence":"additional","affiliation":[{"name":"From the Medtronic, Inc, Minneapolis, MN (K.T.O., J.L.K., P.D.Z.); Centennial Heart, Nashville, TN (P.P.B.); Scripps Clinic, San Diego, CA (J.T.H.); and Cleveland Clinic Foundation, OH (B.L.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi L.","family":"Koehler","sequence":"additional","affiliation":[{"name":"From the Medtronic, Inc, Minneapolis, MN (K.T.O., J.L.K., P.D.Z.); Centennial Heart, Nashville, TN (P.P.B.); Scripps Clinic, San Diego, CA (J.T.H.); and Cleveland Clinic Foundation, OH (B.L.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Thomas","family":"Heywood","sequence":"additional","affiliation":[{"name":"From the Medtronic, Inc, Minneapolis, MN (K.T.O., J.L.K., P.D.Z.); Centennial Heart, Nashville, TN (P.P.B.); Scripps Clinic, San Diego, CA (J.T.H.); and Cleveland Clinic Foundation, OH (B.L.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Ziegler","sequence":"additional","affiliation":[{"name":"From the Medtronic, Inc, Minneapolis, MN (K.T.O., J.L.K., P.D.Z.); Centennial Heart, Nashville, TN (P.P.B.); Scripps Clinic, San Diego, CA (J.T.H.); and Cleveland Clinic Foundation, OH (B.L.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce L.","family":"Wilkoff","sequence":"additional","affiliation":[{"name":"From the Medtronic, Inc, Minneapolis, MN (K.T.O., J.L.K., P.D.Z.); Centennial Heart, Nashville, TN (P.P.B.); Scripps Clinic, San Diego, CA (J.T.H.); and Cleveland Clinic Foundation, OH (B.L.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.743120"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.09.043"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(02)03373-8"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2006.07.030"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.04.015"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.8.878"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.177031"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.112.973776"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.08.624"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.02.014"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.614560"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.968867"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.06.043"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.022"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2012.07.025"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs104"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.03.056"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.10.891"},{"key":"e_1_3_3_21_2","first-page":"ii46","article-title":"Cardiac resynchronization therapy in patients with atrial fibrillation: the CERTIFY study.","volume":"15","author":"Gasparini M","year":"2013","unstructured":"Gasparini M, Leclercq C, Lunati M, Landolina M, Auricchio A, Santini M, Boriani G, Proclemer A, Curnis A, Leyva F. 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