Heart failure & cardiomyopathies
Safety and Efficacy of Adaptive Atrial Pacing Regulated by Blood Pressure During Low-Level Exercise: A Proof-of-Concept Study
Primary result · Exercise duration (modified Bruce treadmill test)Result — go to the resultMean increase 117 sAuthors' conclusion
An increase in exercise duration was reported in HFpEF subjects using a pacing algorithm that modulated HR based on BP compared with standard programming.
Study context
- Population
- Heart failure with preserved ejection fraction (HFpEF) associated with hypertension with permanent dual-chamber pacemakers; mean age 70.1 ± 6.8 years, LVEF 54.8 ± 1.9%crossover
- Participants
- 10 participants
- Comparison
- Blood pressure (BP)-regulated adaptive atrial pacing vs standard pacemaker programming
Methodological detailsprospective, double-blind, non-significant risk, 2 centres, Tests at least 1 week apart, Subjects and clinical staff blinded; only pacemaker technician unblinded
- Prospective
- Double-blind
- Non-significant risk
- 2 centres
- Tests at least 1 week apart
- Subjects and clinical staff blinded; only pacemaker technician unblinded
Primary result
As reported in the abstract
Exercise duration (modified Bruce treadmill test)
Mean increase
117 s
P = 0.0016
Further findings
Atrial pacing rate change at t = 2 min
- BPAP: majority of subjects had atrial pacing rate increased an average of 20%
- 60%
- BPAP: algorithm instructed HR to be unchanged in remaining subjects
- 40%
- DDDR: average increase in atrial pacing rate
- 45%
Post-treadmill SBP during recovery · 30 min recovery period
- SBP higher with BPAP; most pronounced immediately post-treadmill, diminishing through recovery; significant at t = 0, 20, and 30 min
Original publication
Safety and Efficacy of Adaptive Atrial Pacing Regulated by Blood Pressure During Low-Level Exercise: A Proof-of-Concept Study. ESC Heart Fail. Published 23 May 2024. doi:10.
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