A new algorithm for optimization of rate-adaptive pacing improves exercise tolerance in patients with HFpEF.
chronotropic incompetence
exercise intolerance
heart failure with preserved ejection fraction
optimization of rate adaptation
permanent VVIR pacing
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
19
09
2019
revised:
03
12
2019
accepted:
05
12
2019
pubmed:
27
12
2019
medline:
2
3
2021
entrez:
27
12
2019
Statut:
ppublish
Résumé
To develop an algorithm for optimization of rate-adaptive pacing settings in heart failure patients with preserved ejection fraction (HFpEF) and permanent cardiac pacing. This is a prospective randomized controlled study. A total of 54 patients with HFpEF, permanent atrial fibrillation (AF), and VVIR pacing were randomized to an intervention group with optimization of rate-adaptation parameters by using cardiopulmonary exercise testing (CPET) and pacemaker stress echocardiography (PASE), and to a control group with conventional programming. CPET, 6-min walk test (6-mwt), echocardiography (echo), Duke Activity Status Index (DASI), and Minnesota questionnaire (MLHFQ) were performed at baseline and after 3 months. PASE was used to exclude exercise-induced ischemia and to determine safe upper sensor rate. Pacing parameters were corrected to achieve optimal heart rate increments of 3-6 bpm for 1 mL/min/kg of VO After 3 months, the intervention group demonstrated significant improvement of VO An algorithm incorporating CPET and PASE for optimal programming of rate-adaptation parameters is a valuable tool to improve exercise capacity in HFpEF patients with permanent AF and VVIR pacing who remain exercise intolerant after conventional programming.
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
223-233Informations de copyright
© 2019 Wiley Periodicals, Inc.
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