Heart failure & cardiomyopathiesRandomised controlled trial
Adaptive blood pressure–modulated atrial pacing in hypertensive heart failure with preserved ejection fraction (HFpEF) patients: a randomized, first-in-human study
- prospective, double-blind, randomized, self-controlled crossover study
- first-in-human
Authors' conclusion
In hypertensive patients with HFpEF and implanted pacemakers, BPAP safely improved exercise capacity and functional status compared to standard pacing. The approach demonstrates feasibility of home-based blood pressure-modulated pacing for physiologic rate adaptation. (NCT06036186)
Study context
- Population
- Patients with treated hypertension and HFpEF with implanted dual-chamber pacemakerspatients, each underwent two 3-week treatment phases in random order
- Participants
- 16 patients
- Comparison
- blood pressure-adaptive atrial pacing vs standard bradycardia pacing
Primary result
As reported in the abstract
Minnesota Living With Heart Failure (MLWHF) score
Further findings
NYHA class improved
P = 0.0455
Mean heart rate · higher during BPAP
P < 0.0001
Systolic blood pressure · no difference
P = 0.68
| Outcome | BPAP | STD | P value |
|---|---|---|---|
| Exercise time | change +83.2 ± 55.6 s | change +70.8 ± 84.4 s | |
| 6MWT distance | change 35.8 ± 29.9 m | change +8.2 ± 40.1 m |
- Exercise time: BPAP P = .005
- Exercise time: STD P = .095
- 6MWT distance: BPAP P = .003
- 6MWT distance: STD P = .6
Original publication
Adaptive blood pressure–modulated atrial pacing in hypertensive HFpEF patients: a randomized, first-in-human study. ESC Heart Fail. Published 19 January 2026. doi:10.1093/eschf/xvaf020
Summarised from the published abstract; every number is checked against it