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Chronotropic Incompetence and Abnormal Heart Rate Recovery Early after Left Ventricular Assist Device Implantation
Author(s) -
DIMOPOULOS STAVROS,
DIAKOS NIKOLAOS,
TSELIOU ELENI,
TASOULIS ATHANASIOS,
MPOUCHLA ANTHI,
MANETOS CHRISTOS,
KATSAROS LAMBROS,
DRAKOS STAVROS,
TERROVITIS JOHN,
NANAS SERAFIM
Publication year - 2011
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2011.03215.x
Subject(s) - medicine , chronotropic , cardiology , ventricular assist device , heart failure , heart rate , blood pressure
Background: Chronotropic response to exercise and heart rate recovery immediately after exercise (HRR 1 ) are valid prognostic markers in patients with chronic heart failure (CHF). The aim of this study was to evaluate heart rate profile during and after exercise in CHF patients early after left ventricular assist device (LVAD) implantation.Methods: We enrolled seven stable consecutive CHF patients (five males, mean age: 45 ± 16 years) after 1 month of LVAD (HeartMate II; Thoratec Corp, Pleasanton, CA, USA) implantation, seven healthy subjects, and 14 patients with advanced HF (HF control group) who performed an incremental symptom‐limited cardiopulmonary exercise testing (CPET). CHF patients performed CPET at 1 and 3 months after LVAD. HRR 1 was defined as the HR difference from peak to 1 minute after exercise and chronotropic response to exercise as the chronotropic reserve ([CR, %]=[peak HR‐resting HR/220‐age‐resting HR]× 100).Results: LVAD patients 3 months after implantation had a significantly different HR profile during exercise compared to healthy controls, with significantly lower CR (57 ± 31 vs 90 ± 14, %, P < 0.001) and HRR 1 (14 ± 6 vs 28 ± 8, bpm, P < 0.01). HR profile during exercise did not significantly change 1 and 3 months after LVAD implantation. There was no statistical difference compared to HF control group and LVAD group regarding cardiopulmonary parameters.Conclusions: LVAD patients present an impaired CR and an abnormal HRR 1 after implantation, indicating significant cardiac autonomic abnormalities. These alterations seem to remain unaltered 3 months after LVAD implantation. (PACE 2011; 34:1607–1614)