Research output: Contribution to journal › Article › peer-review
Long-Term Outcomes of Drug-Refractory Atrial Fibrillation After Atrioventricular Node Ablation Combined with Implantation of a Cardiac Resynchronization Therapy Defibrillator (CRT-D). / Akhyt, Bagdat A.; Berkinbaev, Salim F.; Lozhkina, Natalya G. et al.
In: Journal of Clinical Medicine, Vol. 14, No. 24, 8938, 18.12.2025.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Long-Term Outcomes of Drug-Refractory Atrial Fibrillation After Atrioventricular Node Ablation Combined with Implantation of a Cardiac Resynchronization Therapy Defibrillator (CRT-D)
AU - Akhyt, Bagdat A.
AU - Berkinbaev, Salim F.
AU - Lozhkina, Natalya G.
AU - Artemenko, Sergey N.
AU - Zyatkov, Nikolay Yu
AU - Krivorotko, Olga I.
AU - Koshumbayeva, Kulzida M.
AU - Pashimov, Marat O.
AU - Tuleutayev, Rustem M.
AU - Kultanova, Elmira B.
N1 - Long-Term Outcomes of Drug-Refractory Atrial Fibrillation After Atrioventricular Node Ablation Combined with Implantation of a Cardiac Resynchronization Therapy Defibrillator (CRT-D) / B. A. Akhyt, S. F. Berkinbaev, N. G. Lozhkina [et al.] // Journal of Clinical Medicine. – 2025. – Vol. 14. - No. 24. – P. 8938. – DOI 10.3390/jcm14248938. – EDN AMBFGC. The work was performed according to the Government research assignment for Sobolev Institute of Mathematics SB RAS, project FWNF-2024-0002 “Inverse ill-posed problems and machine learning in biological, socio-economic and ecological processes”.
PY - 2025/12/18
Y1 - 2025/12/18
N2 - Objective: In this study, we aimed to determine the most significant risk factors for 5-year mortality in patients with paroxysmal and persistent drug-refractory tachysystolic atrial fibrillation after undergoing atrioventricular node ablation (AVNA) in combination with the implantation of a permanent three-chamber pacemaker with an implantable cardioverter–defibrillator function (CRT-D). Methods: This prospective single-center cohort study included 101 patients with chronic heart failure (mean age 62 ± 15.5 years; 70.3% male) with paroxysmal or persistent drug-refractory atrial fibrillation who underwent atrioventricular node ablation and CRT-D implantation. All patients received optimal medical therapy before and after undergoing the procedure. Predictors of 5-year mortality were assessed using exploratory machine-learning methods, including random forest and Shapley additive explanations. Results: During 5-year follow-up, 13 cardiovascular deaths were recorded. Five key predictors of mortality were identified: left ventricular ejection fraction, 6 min walk distance, mean pulmonary artery pressure, systolic relaxation coefficient, and degree of mitral regurgitation. The exploratory predictive model showed high accuracy (92%) in terms of classifying the outcomes. Conclusions: Atrioventricular node ablation (AVNA) combined with CRT-D was associated with the observed long-term clinical outcomes observed in patients with drug-refractory tachysystolic atrial fibrillation. The exploratory machine learning analysis identified key mortality-associated factors, which may support future efforts in personalized risk stratification and hypothesis generation. The combination of AVNA and CRT-D was associated with the observed long-term outcomes in this real-world cohort.
AB - Objective: In this study, we aimed to determine the most significant risk factors for 5-year mortality in patients with paroxysmal and persistent drug-refractory tachysystolic atrial fibrillation after undergoing atrioventricular node ablation (AVNA) in combination with the implantation of a permanent three-chamber pacemaker with an implantable cardioverter–defibrillator function (CRT-D). Methods: This prospective single-center cohort study included 101 patients with chronic heart failure (mean age 62 ± 15.5 years; 70.3% male) with paroxysmal or persistent drug-refractory atrial fibrillation who underwent atrioventricular node ablation and CRT-D implantation. All patients received optimal medical therapy before and after undergoing the procedure. Predictors of 5-year mortality were assessed using exploratory machine-learning methods, including random forest and Shapley additive explanations. Results: During 5-year follow-up, 13 cardiovascular deaths were recorded. Five key predictors of mortality were identified: left ventricular ejection fraction, 6 min walk distance, mean pulmonary artery pressure, systolic relaxation coefficient, and degree of mitral regurgitation. The exploratory predictive model showed high accuracy (92%) in terms of classifying the outcomes. Conclusions: Atrioventricular node ablation (AVNA) combined with CRT-D was associated with the observed long-term clinical outcomes observed in patients with drug-refractory tachysystolic atrial fibrillation. The exploratory machine learning analysis identified key mortality-associated factors, which may support future efforts in personalized risk stratification and hypothesis generation. The combination of AVNA and CRT-D was associated with the observed long-term outcomes in this real-world cohort.
KW - atrial fibrillation
KW - atrioventricular node ablation
KW - cardiac resynchronization therapy defibrillator (CRT-D)
KW - congestive heart failure
KW - long-term mortality
UR - https://www.scopus.com/pages/publications/105026017124
UR - https://elibrary.ru/item.asp?id=88251816
UR - https://www.mendeley.com/catalogue/e814cdc7-e468-3258-b822-3bce88aa629d/
U2 - 10.3390/jcm14248938
DO - 10.3390/jcm14248938
M3 - Article
VL - 14
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
SN - 2077-0383
IS - 24
M1 - 8938
ER -
ID: 74603868