The Effect Of Optimal Cardiac Resynchronization Therapy Pacing Rate In Non-Ischemic Heart Failure Patients On The Quality Of Life And Echocardiographic Findings.

Document Type : Original Article

Authors

Cardiology department, Faculty of Medicine, Beni-Suef University, Egypt.

Abstract

Cardiac resynchronization therapy (CRT) has become an important treatment strategy for a select group of heart failure (HF) patients, few studies have examined the optimal basal atrial pacing rate and its impact on long-term outcome in CRT patients.
30 CRT patients were divided to two groups and programmed to 70 – 80 bpm basal atrial pacing rates respectively for 6 months with comparing the effect of each programming on the quality of life using Minnesota heart failure questionnaire and echocardiographic findings ( EF, LVEDD , LVESD , LVEDV, LVESV ).
There was a highly significant difference between both groups as group 2 (with basal heart rat=80) had higher MFHQ after the programming with mean=67.2 ±9.1 vs group 1 (with basal heart rate =70) with mean 50.6 ±8.3 (P-value<0.001).Also, there was no significant effect of the programming on NYHA of group I (P-value=0.301) but, the programming increase the NYHA of group II significantly (P-value=0.014). The programming didn’t affect the (EF, LVEDD, LVESD, LVEDV, LVESV) of both groups significantly (p-value = 0.916, 0.786 for both groups). The lower basal trial pacing rate the better quality of life and the lower NYHAclass.

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  1. Jessup M, Brozena S. Heart failure. The New England journal of medicine. 2003;348(20):2007-18.
  2. Jaffe LM, Morin DP. Cardiac resynchronization therapy: history, present status, and future directions. The Ochsner journal. 2014;14(4):596-607.
  3. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NM, Freedman RA, Gettes LS, et al. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Journal of the American College of Cardiology. 2008;51(21):e1-e62.
  4. Manolis AS. The deleterious consequences of right ventricular apical pacing: time to seek alternate site pacing. Pacing and Clinical Electrophysiology. 2006;29(3):298-315.
  5. Bilbao A, Escobar A, García-Perez L, Navarro G, Quirós R. The Minnesota living with heart failure questionnaire: comparison of different factor structures. Health Qual Life Outcomes. 2016;14:23-.
  6. Ghotbi AA, Sander M, Køber L, Philbert BT, Gustafsson F, Hagemann C, et al. Optimal cardiac resynchronization therapy pacing rate in non-ischemic heart failure patients: a randomized crossover pilot trial. PloS one. 2015;10(9):e0138124.
  7. Logeart D, Gueffet JP, Rouzet F, Pousset F, Chavelas C, Solal AC, et al. Heart rate per se impacts cardiac function in patients with systolic heart failure and pacing: a pilot study. European journal of heart failure. 2009;11(1):53-7.
  8. Barold SS, Ritter P. Devices for Cardiac Resynchronization:: Technologic and Clinical Aspects: Springer US; 2007.