Heart failure & cardiomyopathies
Associations between cardiac resynchronization therapy and clinical outcomes according to the atrial fibrillation status in patients with heart failure with reduced ejection fraction
Main finding · CV death/first HF hospitalizationResult — go to the resultHazard ratio 0.71 95% CI 0.64–0.79Authors' conclusion
A diagnosis of AF was not associated with the likelihood of receiving CRT in real-world HF care, nor did it affect the association between CRT and lower risk of clinical outcomes.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) meeting the guidelines' recommendation for cardiac resynchronization therapy (CRT), Swedish Heart Failure (HF) Registry, 2014–202224.7% received CRT
- Participants
- 3,530 patients
- Exposure
- CRT vs no CRT, according to atrial fibrillation (AF) status
- Outcome
- Composite of:
- Time to first HF hospitalization
- Cardiovascular (CV) death
Methodological detailsSwedish HF Registry
- Swedish HF Registry
Main finding
CV death/first HF hospitalization
Hazard ratio
0.71
95% CI 0.64–0.79
CRTvs No CRT
HR 0.71 (95% CI 0.64–0.79)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause deathRegardless of AF | 0.72 (0.64–0.81) | |
| 0.512Hazard ratio (log scale) |
Individual components of the primary endpoint; total HF hospitalizations
- CRT associated with lower adjusted risk of each component, but not with total number of HF hospitalizations
Likelihood of receiving CRT by AF (AF in 51.6%)
- AF not associated with the likelihood of receiving a CRT
Original publication
Associations between cardiac resynchronization therapy and clinical outcomes according to the atrial fibrillation status in patients with heart failure with reduced ejection fraction. Europace. Published 18 November 2025. doi:10.
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