Abstract
Background The optimal pacing rate during cardiac resynchronization therapy (CRT) is unknown. Therefore, we investigated the impact of changing basal pacing frequencies on autonomic nerve function, cardiopulmonary exercise capacity and self-perceived quality of life (QoL). Methods Twelve CRT patients with non-ischemic heart failure (NYHA class II-III) were enrolled in a randomized, double-blind, crossover trial, in which the basal pacing rate was set at DDD-60 and DDD-80 for 3 months (DDD-R for 2 patients). At baseline, 3 months and 6 months, we assessed sympathetic nerve activity by microneurography (MSNA), peak oxygen consumption (pVO2), N-Terminal pro-brain natriuretic peptide (p-NT-proBNP), echocardiography and QoL. Results DDD-80 pacing for 3 months increased the mean heart rate from 77.3 to 86.1 (p = 0.001) and reduced sympathetic activity compared to DDD-60 (51±14 bursts/100 cardiac cycles vs. 64±14 bursts/100 cardiac cycles, p<0.05). The mean pVO2 increased non-significantly from 15.6±6 mL/min/kg during DDD-60 to 16.7±6 mL/min/kg during DDD-80, and p-NTproBNP remained unchanged. The QoL score indicated that DDD-60 was better tolerated. Conclusion In CRT patients with non-ischemic heart failure, 3 months of DDD-80 pacing decreased sympathetic outflow (burst incidence only) compared to DDD-60 pacing. However, Qol scores were better during the lower pacing rate. Further and larger scale investigations are indicated.
| Original language | English |
|---|---|
| Article number | e0138124 |
| Journal | P L o S One |
| Volume | 10 |
| Issue number | 9 |
| Pages (from-to) | 1-17 |
| Number of pages | 17 |
| ISSN | 1932-6203 |
| DOIs | |
| Publication status | Published - 18 Sept 2015 |
Keywords
- Aged
- Calibration
- Cardiac Resynchronization Therapy
- Cross-Over Studies
- Double-Blind Method
- Exercise Tolerance
- Female
- Heart Failure
- Heart Rate
- Humans
- Male
- Middle Aged
- Natriuretic Peptide, Brain
- Oxygen Consumption
- Peptide Fragments
- Pilot Projects
- Quality of Life