{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T07:10:23Z","timestamp":1775632223854,"version":"3.50.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Whether adding cardiac resynchronization therapy (CRT-D) to an implanted cardioverter\u2013defibrillator alters the risk of atrial fibrillation or other atrial tachyarrhythmias (AF\/AT), or if postimplantation AF\/AT modulate the benefits of CRT-D, remain unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We studied 972 Resynchronization\/Defibrillation in Ambulatory Heart Failure Trial (RAFT) participants without permanent AF, who were randomized to CRT-D (n=495) versus nonresynchronization defibrillator (implanted cardioverter\u2013defibrillator; n=477) within the predefined stratum eligible for an atrial lead. Occurrence of postrandomization AF\/AT was prospectively assessed, and Cox models were used to test the independent association between the postrandomization AF\/AT and the RAFT primary composite outcome of all-cause mortality or hospitalization for heart failure. Over 41 (\u00b119) months, postrandomization AF\/AT occurred in 216 (45.3%) patients randomized to implanted cardioverter\u2013defibrillator and 249 (50.3%) randomized to CRT-D. After adjusting for competing risk of death, randomization to CRT-D increased risk of postrandomization AF\/AT (hazard ratio, 1.20; 95% confidence interval, 1.00\u20131.42;\n              <jats:italic>P<\/jats:italic>\n              =0.045). Postrandomization AF\/AT, which remained paroxysmal in 69.5%, did not reduce biventricular pacing percentage. In adjusted models, postrandomization AF\/AT was not associated with the primary outcome (hazard ratio, 1.04; 95% confidence interval, 0.84\u20131.30). However, AF\/AT was associated with a borderline decreased risk of mortality (hazard ratio, 0.75; 95% confidence interval, 0.58\u20131.00) but increased risk of heart failure hospitalization (hazard ratio, 1.43; 95% confidence interval, 1.08\u20131.90).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In RAFT, nearly half of the patients developed postrandomization AF\/AT, and those randomized to CRT-D had borderline significant higher risk. Postrandomization AF\/AT was associated with risk of heart failure hospitalization, but not with the primary composite outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00251251.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.115.003807","type":"journal-article","created":{"date-parts":[[2016,5,10]],"date-time":"2016-05-10T04:25:22Z","timestamp":1462854322000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Frequency and Outcomes of Postrandomization Atrial Tachyarrhythmias in the Resynchronization\/Defibrillation in Ambulatory Heart Failure Trial"],"prefix":"10.1161","volume":"9","author":[{"given":"Stephen B.","family":"Wilton","sequence":"first","affiliation":[{"name":"From the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (S.B.W., D.V.E., D.G.W.); University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada (E.Y., G.W.); Department of Medicine, Western University, London, United Kingdom (A.S.L.T.); and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (J.S.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek V.","family":"Exner","sequence":"additional","affiliation":[{"name":"From the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (S.B.W., D.V.E., D.G.W.); University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada (E.Y., G.W.); Department of Medicine, Western University, London, United Kingdom (A.S.L.T.); and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (J.S.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. George","family":"Wyse","sequence":"additional","affiliation":[{"name":"From the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (S.B.W., D.V.E., D.G.W.); University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada (E.Y., G.W.); Department of Medicine, Western University, London, United Kingdom (A.S.L.T.); and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (J.S.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Yetisir","sequence":"additional","affiliation":[{"name":"From the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (S.B.W., D.V.E., D.G.W.); University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada (E.Y., G.W.); Department of Medicine, Western University, London, United Kingdom (A.S.L.T.); and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (J.S.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Wells","sequence":"additional","affiliation":[{"name":"From the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (S.B.W., D.V.E., D.G.W.); University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada (E.Y., G.W.); Department of Medicine, Western University, London, United Kingdom (A.S.L.T.); and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (J.S.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony S.L.","family":"Tang","sequence":"additional","affiliation":[{"name":"From the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (S.B.W., D.V.E., D.G.W.); University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada (E.Y., G.W.); Department of Medicine, Western University, London, United Kingdom (A.S.L.T.); and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (J.S.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S.","family":"Healey","sequence":"additional","affiliation":[{"name":"From the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (S.B.W., D.V.E., D.G.W.); University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada (E.Y., G.W.); Department of Medicine, Western University, London, United Kingdom (A.S.L.T.); and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada 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