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Effect of biventricular pacing on heart rate variability in patients with chronic heart failure
Author(s) -
Livanis Efthimios G.,
Flevari Panagiota,
Theodorakis George N.,
Kolokathis Fotis,
Leftheriotis Dionyssios,
Kremastinos Dimitrios Th.
Publication year - 2003
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/s1388-9842(02)00257-x
Subject(s) - medicine , heart failure , cardiology , heart rate , cardiac pacing , blood pressure
Background: Biventricular pacing is emerging as a long‐term therapy for symptomatic heart failure. Analysis of heart rate variability (HRV) has become an important predictive tool in this syndrome. Aim of the study: To assess whether chronic resynchronization therapy can affect HRV in patients with heart failure. Methods and results: Thirteen patients with heart failure were studied (mean age±1 S.E. 65±2.2 years, QRS 195±5.3 ms, NYHA class 3.2±0.1, LVEF 21±1.7%). The protocol included a preliminary no pacing period for 1 month following device implantation. Twenty‐four hour Holter ECG recordings were performed at the end of this period (baseline) and after 3 months of biventricular stimulation (VDD mode). Prior to and following pacing patients underwent NYHA class evaluation, 6‐min walk test, Quality of Life Assessment and a cardiopulmonary exercise test. Biventricular pacing improved functional class ( P <0.0001) and Quality of life ( P <0.0001), increased 6‐min walk distance, ( P =0.008) and exercise duration ( P <0.0001) but had no significant effect on peak exercise VO 2 . Resynchronization therapy increased mean 24‐h RR (922±58 vs. 809±41 ms at baseline, P =0.006), SDNN (111±11 vs. 83±8 ms, P =0.003), SDNN‐I (56±10 vs. 40±5 ms, P =0.02), rMSSD (66±14 vs. 41±8 ms, P =0.003), Total Power (5724±1875 vs. 2074±553 ms 2 , P =0.03), Ultra Low Frequency Power (1969±789 vs. 653±405 ms 2 , P =0.03) and Very Low Frequency Power (2407±561 vs. 902±155 ms 2 , P =0.004). Conclusion: Biventricular pacing in heart failure improves autonomic function by increasing HRV. This may have important prognostic implications.