美托洛尔控制快速房颤患者心室率的安全性及疗效评价

【目的】观察美托洛尔控制快速房颤心室率的有效性及安全性。【方法】选择快速房颤患者 (心室率 >1 0 0次 /min) 98例 ,每隔 2min静脉推注美托洛尔 5mg ,连续 3次 ,1 5min后予美托洛尔片剂 5 0mg ,每 6h一次。观察其有效率 (心室率下降≥ 2 0 % )及症状体征变化。【结果】静脉推注美托洛尔 1 5mg后第 1 0min ,有效率 83.7% ,心室率由基础的 (1 33.7± 1 8.3)次 /min下降至 (91 .4± 1 2 .6 )次 /min ;口服美托洛尔 2 4h后有效率达 93.9% ,心室率下降至 (79.5± 8.9)次 /min。 2例患者出现能耐受的低血压状态 (85～ 90 / 5 5～ 6 0mmHg) ,无严重心动过缓 (心率 <5 0次 /min)及Ⅱ、Ⅲ度房室传导阻滞、心功能恶化及死亡等事件。【结论】静脉应用美托洛尔治疗快速房颤安全有效     

地尔硫(艹卓)、美托洛尔、地高辛控制快速房颤心室率的安全性及疗效评价

目的:观察地尔硫革、美托洛尔、地高辛控制快速房颤心室率的有效性及安全性.方法:选择快速房颤心室率患者(HR＞100次/min)95例采用随机方式分为地尔硫革组(32例),90～240 mg/d,分3次口服;美托洛尔组(32例),12.5～50 mg/d,分2次口服;地高辛组(31例),0.125～0.25 mg/d,1次口服.观察其有效率(心室率下降≥20%)及症状体征变化.结果:地尔硫革、美托洛尔及地高辛控制房颤的快速心率总有效率分别为91%、92%、71%,心室率分别下降为(84.2±21.2)次/min、(83.7±18.9)次/min、(95.3±19.3)次/min,平均起效时间分别为(23.5±5.2)h、(24.5±3.8)h、(45.1±7.5)h,3组复律分别3例、3例、1例,地尔硫革组出现低血压3例,窦性心动过缓1例;美托洛尔组出现低血压4例,窦性心动过缓1例;地高辛组出现窦性心动过缓1例,均自行缓解,未发生心衰加重.结论:与地高辛相比,口服地尔硫革、美托洛尔能有效控制其静息及活动后心室率,起效迅速,且均无明显副反应.     

地尔硫、美托洛尔、地高辛控制快速房颤心室率的安全性及疗效评价

目的观察地尔硫革、美托洛尔、地高辛控制快速房颤心室率的有效性及安全性.方法选择快速房颤心室率患者(HR＞100次/min)95例采用随机方式分为地尔硫革组(32例),90～240 mg/d,分3次口服;美托洛尔组(32例),12.5～50 mg/d,分2次口服;地高辛组(31例),0.125～0.25 mg/d,1次口服.观察其有效率(心室率下降≥20%)及症状体征变化.结果地尔硫革、美托洛尔及地高辛控制房颤的快速心率总有效率分别为91%、92%、71%,心室率分别下降为(84.2±21.2)次/min、(83.7±18.9)次/min、(95.3±19.3)次/min,平均起效时间分别为(23.5±5.2)h、(24.5±3.8)h、(45.1±7.5)h,3组复律分别3例、3例、1例,地尔硫革组出现低血压3例,窦性心动过缓1例;美托洛尔组出现低血压4例,窦性心动过缓1例;地高辛组出现窦性心动过缓1例,均自行缓解,未发生心衰加重.结论与地高辛相比,口服地尔硫革、美托洛尔能有效控制其静息及活动后心室率,起效迅速,且均无明显副反应.     

地尔硫、美托洛尔、地高辛控制快速房颤心室率的安全性及疗效评价

目的:观察地尔硫、美托洛尔、地高辛控制快速房颤心室率的有效性及安全性。方法:选择快速房颤心室率患者(HR>100次/min)95例采用随机方式分为地尔硫组(32例),90～240mg/d,分3次口服;美托洛尔组(32例),12.5～50mg/d,分2次口服;地高辛组(31例),0.125～0.25mg/d,1次口服。观察其有效率(心室率下降≥20%)及症状体征变化。结果:地尔硫、美托洛尔及地高辛控制房颤的快速心率总有效率分别为91%、92%、71%,心室率分别下降为(84.2±21.2)次/min、(83.7±18.9)次/min、(95.3±19.3)次/min,平均起效时间分别为(23.5±5.2)h、(24.5±3.8)h、(45.1±7.5)h,3组复律分别3例、3例、1例,地尔硫组出现低血压3例,窦性心动过缓1例;美托洛尔组出现低血压4例,窦性心动过缓1例;地高辛组出现窦性心动过缓1例,均自行缓解,未发生心衰加重。结论:与地高辛相比,口服地尔硫衦、美托洛尔能有效控制其静息及活动后心室率,起效迅速,且均无明显副反应。     

地高辛合用氨酰心安控制房颤室率的疗效观察

持续性房颤多见于器质性心脏病,对于不易复律的房颤,减慢心室率为治疗的首要措施。我们以地高辛合用小剂量氨酰心安控制持续性房颤心室率,取得了满意效果。现报告如下。 1 对象和方法 1.1 观察对象:口服地高辛0.25mg,每日一次,5天后静息心室率大于85次/分的持续性房颤84例。其中男40例,女44例。平均年龄54±8岁,心功能Ⅱ～Ⅲ级,风心病40例,冠心病24例,高     

综合康复疗法与持续小剂量地高辛治疗老年充血性心衰

目的评价康复疗法与持续小剂量地高辛治疗老年充血性心衰的临床疗效.方法 46例老年慢性充血性心衰患者采用戒烟、修正饮食、调脂、个体化体力运动训练程序等综合康复疗法及持续小剂量地高辛治疗.结果 46例患者治疗后总有效率90%.心输出量(L/min)治疗前后分别为4.33±0.66, 4.80 ±1.22; 左室射血分数 (%)分别为37.85 ±9.9,44.65±10.4;平均心率(次/min) 分别为98±13,78±12 .地高辛过量或中毒的发生率为4.3%.结论综合康复疗法与持续小剂量地高辛联合治疗对老年充血性心衰是一种安全有效的方法.     

胺碘酮与毛花甙C控制快速心房颤动伴充血性心力衰竭患者心室率即时效应及安全性的比较

目的　比较静脉应用胺碘酮与毛花甙C控制快速心房颤动 (简称房颤 )伴充血性心力衰竭(心衰 )患者心室率的即时效应及安全性。方法　 4 6例房颤患者 ,心室率≥ 12 0次 /min ,心功能Ⅱ级以上(NYHA)。采用随机方式分组 ,分别静脉应用胺碘酮、毛花甙C。结果　胺碘酮、毛花甙C组控制房颤快速心室率的总有效率分别为 81 0 %和 60 9% (P <0 0 5 ) ;心室率平均下降幅度分别为 3 5 %和 2 5 % (P <0 0 1) ;平均起效时间分别为 (2 3 1± 8 2 )min和 (5 0 7± 10 4 )min (P <0 0 1)。胺碘酮组有 1例出现症状性低血压 ,1例出现Ⅰ°房室传导阻滞 ,无心衰加重表现。结论　静脉应用胺碘酮能迅速、安全、有效地控制房颤伴充血性心衰患者的快速心室率     

静脉注射美托洛尔对快速型心室率的控制作用

目的探讨静脉注射美托洛尔对快速型心房纤颤和窦性心动过速的即刻治疗作用及安全性。方法选择需要控制心室率治疗的住院患者65例,其中35例为快速型心房纤颤,30例为窦性心动过速。静脉注射美托洛尔5mg,观察心率和血压的变化。结果静脉注射美托洛尔5mg后,快速型心房纤颤患者的心率平均降低(34±13)次/min,下降百分率为(24±8)%(P＜0．01),收缩压平均减少(7±6)mm Hg(P＜0．05)。窦性心动过速患者的心率平均降低(23±11)次/min,下降百分率为(22±7)%(P＜0．01),收缩压平均减少(6±9)mm Hg(P＜0．05)。两组患者的舒张压治疗前后均无显著改变。快速型心房纤颤患者的心率下降绝对值与窦性心动过速患者相比差异有统计学意义。所有患者的心率改变在静脉注射美托洛尔后5 min内出现,无明显不良反应。结论静脉注射美托洛尔可迅速、有效、安全地降低经过选择的快速型心房纤颤和窦性心动过速患者的心率,对血压的控制不是其主要作用。     

静脉注射胺碘酮、美托洛尔控制心房颤动时快速心室率的临床评价

目的观察胺碘酮、美托洛尔静脉制剂用于控制心房颤动时快速心室率的临床疗效和安全性。方法82例持续性房颤患者分别接受静脉胺碘酮（A组）和美托洛尔（B组）治疗。结果两组患者治疗后心室率明显降低，A组42例，心室率平均下降（27±7）次／min，B组40例，心室率平均下降（26±9）次／min，美托洛尔组有4例用药后心力衰竭加重，1例发生窦性停搏5．2S，不良反应发生率12．5％，而胺碘酮组所有患者未因药物副作用而终止治疗。结论胺碘酮和美托洛尔静脉应用均能较好控制心房颤动时的快速心室率，胺碘酮较美托洛尔更安全。     

美托洛尔联合地高辛对快速房颤的临床疗效分析

目的观察美托洛尔联合地高辛治疗房颤的临床疗效和安全性。方法将86例房颤患者随机分为2组,对照组43例单纯给予地高辛治疗,治疗组43例给予地高辛＋美托洛尔治疗,观察2组患者治疗前后心功能、心率和生活质量变化等指标。结果治疗组运动心率、心功能及生活质量改善情况明显优于对照组;治疗组总有效率（90.7%）显著高于对照组（72.1%）,差异均有统计学意义;2组不良反应无显著差异。结论美托洛尔联合地高辛是控制快速房颤心室率安全有效的方案。     

非瓣膜性心房颤动患者及窦性心律者左心耳排空流速与左房功能参数的相关性研究

目的 应用经食管超声心动图(TEE)检测非瓣膜性心房颤动(以下简称房颤)患者及窦性心律者左心耳排空流速(LAAFV)，探讨其与经胸超声心动图(TTE)所测左房功能参数的相关性。方法 选取我院窦性心律者60例(窦性心律组)和非瓣膜性房颤患者30例(房颤组)。应用TTE获取左房收缩末期前后径(LADd_前后)、左右径(LADd_左右)、上下径(LADd_上下)，以及左室舒张末期内径、左室射血分数(LVEF)；斑点追踪技术获取左房储器期应变(LASr)、管道期应变(LAScd)、泵功能期应变(LASct)，以及左室整体纵向应变(LVGLAS)、左房收缩末期最大容积(LAVmax);TEE检测LAAFV。比较两组上述各参数的差异；分析窦性心律组和房颤组LAAFV与TTE所测左房功能参数的相关性。结果 房颤组LVEF、LVGLAS、LASr、LAScd、LASct、LAAFV均小于窦性心律组，LADd_前后、LADd_左右、LADd_上下、LAVmax均大于窦性心律组，两组比较...     

Chronic Rapid Atrial Pacing to Maintain Atrial Fibrillation: Use to Permit Control of Ventricular Rate in Order to Treat Tachycardia Induced Cardiomyopathy

LR was a patient, followed over a 16-year period, who presented with an atrial tachycardia which was initially intermittent, but became incessant. Neither the atrial tachycardia nor the associated rapid ventricular response rate could be treated successfully with available drug therapy, resulting in a dilated cardiomyopathy and New York Heart Association (NYHA) class III-IV congestive heart failure. Acute induction of atrial fibrillation with rapid atrial pacing demonstrated that the associated ventricular rate could be satisfactorily slowed with digitalis therapy. Initially, short bursts from an implanted, radiofrequency controlled, patient activated pacemaker programmed to a rate of 600 bpm and connected to a permanent endocardial atrial J lead successfully interrupted the tachycardia and precipitated atrial fibrillation. Over a period of 3 months, this therapy changed the patient's heart failure to NYHA class II status. Subsequently, precipitation of atrial fibrillation with this technique failed, resulting in return to NYHA class III-IV congestive heart failure. Therefore, a custom-designed, high rate, rate-programmable pacemaker was implanted to pace the atria rapidly and continuously to maintain atrial fibrillation. A pacing rate of 375 bpm plus digoxin slowed the ventricular rate to 70-80 bpm, with stabilization of the congestive heart failure to NYHA class II. The pacemaker generator was replaced 6 months later, and after another 5 months, pacing was discontinued. The patient's subsequent rhythm remained stable atrial fibrillation with clinically successful control of both the ventricular rate and heart failure (NYHA class II) until the patient's death 72 months later. This unique case demonstrates another form of chronic therapy which, in selected cases, can be used for the long term control of rapid ventricular response rates to supraventricular arrhythmia.     

心房纤颤心室率对心力衰竭患者血清NT-proBNP浓度的影响

目的 探讨心房纤颤(简称房颤)心室率对心力衰竭患者血清N-端脑利钠肽前体(NT-proBNP)浓度的影响.方法入选101例心力衰竭患者,按心电图诊断分为快速型房颤组(心室率大于100次/分,n=33)、普通型房颤组(心室率60～100次/分,n=32)和窦性心律组(n=36),再按纽约心脏病协会(NYHA)心功能分级标准分为心功能Ⅱ、Ⅲ和Ⅳ级3个亚组.采用胶体金法检测受试者血清NT-proBNP浓度并进行统计学分析.结果快速型房颤组、普通型房颤组及窦性心律组患者血清NT-proBNP浓度随NYHA心功能分级增加呈增高趋势,每组各亚组间比较差异有统计学意义(P＜0.05).窦性心律组、普通型房颤组、快速型房颤组患者血清NT-proBNP浓度在一定程度上呈增高趋势,但组间比较差异无统计学意义(P>0.05).在相同心功能分级亚组,快速型房颤组患者血清NT-proBNP浓度显著高于窦性心律组和普通型房颤组(P＜0.05),而普通型房颤组与窦性心律组比较,差异无统计学意义(P>0.05).结论 血清NT-proBNP浓度与心力衰竭严重程度相关;房颤对心力衰竭患者血清NT-proBNP浓度有一定影响,房颤心室率增快(超过100次/分)对血清NT-proBNP浓度影响越明显.     

Effect of landiolol hydrochloride, an ultra-short-acting beta 1-selective blocker, on supraventricular tachycardia, atrial fibrillation and flutter after pulmonary resection

What is known and objective: Supraventricular tachycardia is a common complication after pulmonary resection. The objective of this study was to investigate the efficacy of landiolol hydrochloride, an ultra‐short‐acting β1‐blocker, in patients with post‐operative supraventricular tachycardia after pulmonary resection. Methods: The response to continuous intravenous infusion of landiolol was evaluated in 25 patients who developed post‐operative atrial fibrillation or atrial flutter after major pulmonary resection. Four patients had preoperative rate‐controlled chronic atrial fibrillation. The heart rate and blood pressure were compared before and after infusion of landiolol. Side effects and recurrence of supraventricular tachycardia after termination of landiolol infusion were also monitored. Results and discussion: The heart rate was reduced from 135 ± 24 bpm before landiolol infusion to a plateau rate of 85 ± 19 bpm during infusion (P < 0·0001). Heart rate reduction occurred in all but two patients. Conversion to normal sinus rhythm from supraventricular tachycardia occurred in 14 patients (56%). Recurrence of supraventricular tachycardia after stopping landiolol infusion was observed in 17 patients (68%), but all patients without preoperative AF were cured of post‐operative AF. There were no detectable side effects, including no adverse influence on the circulatory and respiratory systems. What is new and conclusion: Continuous intravenous infusion of landiolol was found to be effective and safe for supraventricular tachycardia after pulmonary resection.     

围术期应用胺碘酮预防心脏不停跳冠状动脉搭桥术后房颤的研究

目的探讨围手术期应用胺碘酮在预防非体外循环下心脏不停跳冠状动脉搭桥术后房颤中的作用。方法采用随机对照的研究方法,将2009年1月至2011年1月在我科进行非体外循环下心脏不停跳冠状动脉搭桥术的患者随机分为试验组和对照组,每组各100例。A组为试验组,术前口服胺碘酮,600mg/d(200mgtid),连续7d,之后改为200mg/d至术前,术后当天开始静脉滴注胺碘酮,负荷量为5mg/kg,之后给予维持量0.5mg.kg-1.h-1,能进食后改为200mg/d口服。B组为对照组,不给予胺碘酮治疗而仅用常规药物。观察两组患者术后房颤发生率及心率变化,同时检测试验组患者术前及术后第2天的胺碘酮血药浓度。结果两组患者的术前一般特征及手术情况相近。试验组100例患者中术后有10例(10.0%)发生房颤,对照组100例患者中有36例(36.0%)发生房颤(P=0.015)。试验组房颤时最大心室率为(126.0±20.8)次/min,房颤持续时间为1.0d,对照组房颤时最大心室率为(150.0±25.6)次/min,房颤持续时间为(3.0±1.5)d(P<0.05)。试验组术后心率慢于对照组,两组Q-T间期、术后并发症的发生及死亡率无统计学差异。试验组的住院时间为(10.6±2.8)d,对照组住院时间为(15.4±3.2)d(P<0.05)。胺碘酮血药浓度平均值术前为(797±136)ng/ml,术后第2天为(763±94)ng/ml(P>0.05)。结论胺碘酮在预防非体外循环下心脏不停跳冠状动脉搭桥术后房颤中的作用显著,能安全有效地降低术后房颤的发生率,缩短房颤持续时间,且无明显不良反应。     

Metoprolol in the treatment of supraventricular tachyarrhythmias.

Twenty one patients with either paroxysmal supraventricular tachycardia (group A), atrial flutter (group B), or atrial fibrillation (group C) were treated with intravenous metoprolol in the dose range 2--20 mg. Sinus rhythm was restored in 3 out of 6 patients in group A, 3 out of 7 patients in group B and one out of 8 patients in group C. In patients who did not convert to sinus rhythm a remarkable decrease in ventricular rate occurred in 3 patients with atrial flutter and 4 patients with atrial fibrillation. In patients with systolic blood pressure greater than 100 mm Hg but without an acute myocardial infarction the risk of hypotension necessitating treatment was small. Metoprolol appears to be an effective and safe drug in the treatment of supraventricular tachycardia.     

Does acute-phase beta blockade reduce left atrial appendage function in patients with chronic nonvalvular atrial fibrillation?

To investigate whether acute-phase beta-blocker therapy has a harmful effect on left atrial appendage (LAA) function in patients with chronic nonvalvular atrial fibrillation by transesophageal echocardiography (TEE), we evaluated 21 patients with normal left ventricular systolic function and a poorly controlled ventricular rate, despite the use of digoxin. Baseline parameters that were obtained included heart rate, blood pressure, LAA emptying velocities, and left atrial spontaneous echo contrast intensity. Then, each patient was given a bolus dose of 5 mg metoprolol. Ten minutes later, a second set of assessments was performed. After the first TEE studies, each patient began treatment with metoprolol (50 mg orally twice daily for 1 week). A second TEE study was performed after 1 week of continuous oral metoprolol therapy at maintenance dose, and values were again determined. The average resting apical heart rate was 91 +/- 7 bpm. As expected, beta-blocker therapy showed a marked decrease in heart rate at 10 minutes (79 +/- 6 bpm, P <.001) and at 1 week (71 +/- 4 bpm, P <.001). Beta-blocker therapy caused a significant reduction in systolic and diastolic blood pressures (144 +/- 16 / 93 +/- 6 mm Hg at baseline, 137 +/- 16 / 87 +/- 9 mm Hg at 10 minutes, and 135 +/- 12 / 86 +/- 8 mm Hg at 1 week, P <.001). With the beta-blocker therapy, the baseline transesophageal Doppler parameter of LAA emptying velocities (at baseline 24 +/- 7 cm/s) fell significantly at 10 minutes (19 +/- 7 cm/s, P <.001) and at 1 week (17 +/- 6 cm/s, P <.001) after initiation of beta-blocker therapy. After a bolus of metoprolol, spontaneous echo contrast intensity did not change in any patients, but 1 week later, it increased in 1 patient. In 2 patients who had not been found to have an LAA thrombus at baseline TEE study, the second TEE examination demonstrated new thrombi in the LAA. In conclusion, our findings suggest that in patients with chronic nonvalvular atrial fibrillation who have normal left ventricular systolic function and a poorly controlled ventricular rate despite the use of digoxin, acute-phase beta blockade may have a harmful effect on LAA function.     

Disposition and pharmacologic effects of R/S-verapamil in patients with chronic atrial fibrillation: an investigation comparing single and multiple dosing

BACKGROUND: Racemic (R /S)- verapamil is widely used in the management of chronic atrial fibrillation. The negative dromotropic effect is mainly mediated by the S -enantiomer, which is preferentially metabolized. Previous studies report an accumulation of R /S- verapamil during long-term oral treatment of patients with chronic atrial fibrillation. However, the specific disposition of S -verapamil and the pharmacologic effects were not assessed. Therefore uncertainties about the need for dose adjustments remain. METHODS: Using stable isotope technology and a stereospecific assay, we compared the pharmacokinetics and pharmacodynamics of intravenous (10 mg of d(7)-R /S -verapamil) and oral (240 mg of slow release (SR) d(0)-R /S -verapamil) R -verapamil and S -verapamil after the first dose (day 1) and after 3 weeks (day 21) of continuous oral therapy in 8 patients with long-term atrial fibrillation. On both study days, serum samples were obtained for the analysis of d(7)- and d(0)-R -verapamil and S -verapamil. Heart rate (HR) was monitored with electrocardiography (with each blood sample) and Holter electrocardiography (before the study, on day 1, and on day 21). RESULTS: Compared with day 1, clearance of oral R -verapamil and S -verapamil was significantly reduced on day 21 (1007 +/- 380 versus 651 +/- 253 mL/min [-35%] and 5481 +/- 2731 versus 2855 +/- 1097 mL/min [-48%], respectively; P <.05), whereas only a moderate decrease was observed for intravenous R -verapamil and S -verapamil (-23% and -14%, respectively, not significant). Mean HR (89 +/- 11 bpm before verapamil) was effectively reduced, with the same effects on day 1 (68 +/- 8 bpm) and day 21 (68 +/- 8 bpm). Compared with day 1, the HR reduction per ng/mL of S -verapamil (calculated by the area under the curve [from 0-24 hours] ratio of HR reduction and S -verapamil concentration) was significantly lower on day 21 (0.7 +/- 0.4 versus 1.2 +/- 0.7 [bpm]. [ng/mL](-1), for day 21 versus day 1; P <.01). CONCLUSIONS: In patients with chronic atrial fibrillation, clearance of oral, but not intravenous, S -verapamil and R -verapamil is significantly reduced with multiple doses compared with a single dose, thereby indicating predominant impairment of prehepatic rather than hepatic metabolism as the underlying mechanism. However, this kinetic change is clinically compensated by a decrease in the responsiveness to S -verapamil observed with regular dosing. The data suggest that despite accumulation of the drug individual verapamil doses can be maintained during long-term oral rate control therapy.     

Antiarrhythmic effects of intravenous timolol in supraventricular arrhythmias

The antiarrhythmic effect of timolol was investigated in 160 subjects with supraventricular arrhythmias. In our double-blind, randomized, parallel, multiclinic study, subjects received timolol, 1 mg iv, or matching placebo as a starting dose, followed by a second and third dose of 1 mg each (or matching placebo) at 20-min intervals if the arrhythmia did not convert to sinus rhythm. Subjects in whom the sinus rhythm returned or the ventricular rate decreased to less than 100 bpm were transferred to a dosing regimen of timolol in 10-mg tablets twice a day by mouth, 1 hr after the last intravenous dose. Data indicated that the mean decrease in heart rate was 44 bpm after timolol and 7 bpm after placebo. The overall proportion of responders (either conversion to sinus rhythm or a decrease in ventricular rate to less than 100 bpm) was 68% after timolol and 7% after placebo. The proportions of responders after timolol were significantly higher than the proportions after placebo for paroxysmal supraventricular tachycardia (26 of 32 subjects and two of 38 subjects), atrial fibrillation (17 of 29 subjects and three of 32 subjects), and atrial flutter (seven of 11 subjects and one of nine subjects). The most common adverse effects were bradycardia and hypotension.     

Effect of cardiac resynchronization therapy on conversion of persistent atrial fibrillation to sinus rhythm

Background  Spontaneous conversion of persistent atrial fibrillation to sinus rhythm (SR) has anecdotally been reported following cardiac resynchronisation therapy. Objective  This monocenter observational study was designed to estimate the incidence of spontaneous conversion of persistent atrial fibrillation to SR in consecutive patients implanted with a cardiac resynchronisation device. Methods and results  A total of 46 patients with persistent atrial fibrillation (≥4 weeks pre-implant), left bundle branch block (QRS > 130 ms), left ventricular ejection fraction <0.35 and NYHA III or IV heart failure were implanted with a cardiac resynchronisation pacemaker or defibrillator and followed for at least 6 months between 6/2000 to 12/2006. During 22 ± 9 (7–34) months of follow-up, eight out of 46 patients (17%) converted to SR. Spontaneous conversion was encountered in seven cases, whereas one patient converted due to an ICD shock delivered for ventricular tachycardia; in the latter patient, previous ICD shocks had not converted atrial fibrillation. The time interval from device implantation to conversion was 12 ± 11 (3–31) months. In patients converting to SR, the duration of atrial fibrillation before device implantation was significantly shorter than in patients remaining in atrial fibrillation (15 ± 13 vs. 53 ± 58 months, P = 0.001). Echocardiographic parameters such as left ventricular ejection fraction, left ventricular enddiastolic diameter, left atrial diameter did not differ significantly between converting and non-converting patients. However, patients converting to SR showed a significant reduction in systolic pulmonary artery pressure on CRT vs. before CRT (45 ± 13 vs. 29 ± 5 mmHg, P = 0.008). Conclusions  This pilot study suggests that CRT favors spontaneous conversion of persistent AF to SR in a minority of patients. If confirmed by larger clinical studies, atrial lead implantation would be encouraged in these patients, in order to provide AV synchronous pacing in case of spontaneous conversion or successful cardioversion to SR on cardiac resynchronisation therapy. M. Hauck and A. Bauer contributed equally to this work.