Heart failure & cardiomyopathies
Clinical Outcomes With Personalized Accelerated Physiologic Pacing in Heart Failure With Preserved Ejection Fraction: Follow-up of the myPACE Trial
Authors' conclusion
In this observational clinical events analysis of the myPACE trial, analysis by ITT did not achieve statistical significance between study arms. However, PP analysis showed that personalized accelerated physiologic pacing was associated with a slower accrual of adverse clinical events compared with the standard 60-bpm setting.
Study context
- Population
- Patients with stage B or C heart failure with preserved ejection fraction (HFpEF) and preexisting physiologic pacemakers, University of Vermont Medical Center87 in per-protocol (PP) analysis
- Participants
- 100 patients
- Comparison
- Personalized accelerated pacing vs 60 bpm
- myPACEn = 48
- Usual caren = 52reference
- Primary endpoint
- Accrual of first and recurrent adverse clinical events (urgent visits or hospitalizations for HF or AF, MI, stroke, or death)
- Follow-up
- Up to 4 years
Methodological detailsopen-label follow-up, single-centre, ITT and prespecified per-protocol analyses, Results primarily driven by HF-related events
- Open-label follow-up
- Single-centre
- ITT and prespecified per-protocol analyses
- Results primarily driven by HF-related events
Primary result
As reported in the abstract
Event accrual (ITT)
LWYY
0.48
95% CI 0.22–1.06P = 0.07
ITT
LWYY
0.16
95% CI 0.04–0.67P = 0.01
prespecified PP (n = 87): 5 vs 31 events
myPACE
15
events
Usual care
33
events
Secondary outcomes
| Outcome | HR for first adverse clinical event (95% CI) | P value | |
|---|---|---|---|
| Event-free survival (ITT)Intention-to-treat | 0.63 (0.31–1.29) | P = 0.20 | |
| Event-free survival (PP)Longer event-free survival with myPACE | 0.30 (0.11–0.80) | P = 0.02 | |
| 0.10.31310HR for first adverse clinical event (log scale) |
- Event-free survival (PP): prespecified per-protocol analysis (n = 87)
Original publication
Clinical Outcomes With Personalized Accelerated Physiologic Pacing in Heart Failure With Preserved Ejection Fraction: Follow-up of the myPACE Trial. JAMA Cardiol. Published 1 October 2025. doi:10.
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