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Conference Paper: Incremental benefit of rate adaptive pacing on exercise performance during cardiac resynchronization therapy

TitleIncremental benefit of rate adaptive pacing on exercise performance during cardiac resynchronization therapy
Authors
Issue Date2005
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal
Citation
The 2005 Annual Scientific Sessions of the Heart Rhythm Society (Heart Rhythm 2005), New Orleans, LA., 4-7 May 2005. In Heart Rhythm, 2005, v. 2 n. 5 suppl., p. S166-S167, abstract no. P2-101 How to Cite?
AbstractBACKGROUND: Cardiac resynchronization therapy (CRT) improves exercise capacity in patients (pts) with left bundle branch block (LBBB) and heart failure. However, pharmacologic treatment with -blockers and/or coexisting chronotropic incompetence frequently limit an increase in heart rate during exercise in pts with heart failure, which may have negative effect on the exercise capacity. The potential incremental benefits of using rate adaptive sensor and atrioventricular interval (AVI) adaptation in CRT during exercise have not been studied. METHODS AND RESULTS: We studied the exercise performance in 21 pts (15 males, mean age: 70 9 years) with LBBB (mean QRS duration 176 22 ms) and heart failure (76% nonischemic cardiomyopathy, mean ejection fraction: 24 10%) implanted with CRT for 12 months. All pts received stable medications (86% on -blockers) and their device AVI was optimized by using Ritter’s formula (mean 101 21 ms). All pts underwent cardiopulmonary exercise treadmill test with their pacemaker programmed to 1) DDD mode with fixed AVI (DDD-off); 2) DDD mode with adaptive AVI algorithm on (DDD-on) and 3) DDDR mode with adaptive AVI algorithm on (DDDR-on) in a randomized fashion. The minimum AVI was 76 11 ms using adaptive AVI algorithm at the maximum exercise heart rate. The maximum heart rate achieved during peak exercise was significantly higher with DDDR-on mode than DDD-off and DDD-on mode (Figure 1). Both DDD-on and DDDR-on mode increased the exercise time compared to DDD-off mode (Figure 2). However, the use of DDDR-on mode further increased peak oxygen consumption (VO2 max) compared to DDD-off and DDD-on mode (Figure 3). CONCLUSIONS: In heart failure pts implanted with CRT, the use of rate adaptive pacing and adaptive AVI algorithm can further enhance their exercise performance by reducing chronotropic incompetence during exercise.
DescriptionPoster 2: no. P2-101
Persistent Identifierhttp://hdl.handle.net/10722/101012
ISSN
2015 Impact Factor: 4.391
2015 SCImago Journal Rankings: 2.756

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorLee, KLFen_HK
dc.contributor.authorChan, HWen_HK
dc.contributor.authorTang, MOen_HK
dc.contributor.authorTsang, VYCen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-09-25T19:32:26Z-
dc.date.available2010-09-25T19:32:26Z-
dc.date.issued2005en_HK
dc.identifier.citationThe 2005 Annual Scientific Sessions of the Heart Rhythm Society (Heart Rhythm 2005), New Orleans, LA., 4-7 May 2005. In Heart Rhythm, 2005, v. 2 n. 5 suppl., p. S166-S167, abstract no. P2-101-
dc.identifier.issn1547-5271en_HK
dc.identifier.urihttp://hdl.handle.net/10722/101012-
dc.descriptionPoster 2: no. P2-101-
dc.description.abstractBACKGROUND: Cardiac resynchronization therapy (CRT) improves exercise capacity in patients (pts) with left bundle branch block (LBBB) and heart failure. However, pharmacologic treatment with -blockers and/or coexisting chronotropic incompetence frequently limit an increase in heart rate during exercise in pts with heart failure, which may have negative effect on the exercise capacity. The potential incremental benefits of using rate adaptive sensor and atrioventricular interval (AVI) adaptation in CRT during exercise have not been studied. METHODS AND RESULTS: We studied the exercise performance in 21 pts (15 males, mean age: 70 9 years) with LBBB (mean QRS duration 176 22 ms) and heart failure (76% nonischemic cardiomyopathy, mean ejection fraction: 24 10%) implanted with CRT for 12 months. All pts received stable medications (86% on -blockers) and their device AVI was optimized by using Ritter’s formula (mean 101 21 ms). All pts underwent cardiopulmonary exercise treadmill test with their pacemaker programmed to 1) DDD mode with fixed AVI (DDD-off); 2) DDD mode with adaptive AVI algorithm on (DDD-on) and 3) DDDR mode with adaptive AVI algorithm on (DDDR-on) in a randomized fashion. The minimum AVI was 76 11 ms using adaptive AVI algorithm at the maximum exercise heart rate. The maximum heart rate achieved during peak exercise was significantly higher with DDDR-on mode than DDD-off and DDD-on mode (Figure 1). Both DDD-on and DDDR-on mode increased the exercise time compared to DDD-off mode (Figure 2). However, the use of DDDR-on mode further increased peak oxygen consumption (VO2 max) compared to DDD-off and DDD-on mode (Figure 3). CONCLUSIONS: In heart failure pts implanted with CRT, the use of rate adaptive pacing and adaptive AVI algorithm can further enhance their exercise performance by reducing chronotropic incompetence during exercise.-
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournalen_HK
dc.relation.ispartofHeart Rhythmen_HK
dc.rightsHeart Rhythm. Copyright © Elsevier Inc.en_HK
dc.titleIncremental benefit of rate adaptive pacing on exercise performance during cardiac resynchronization therapyen_HK
dc.typeConference_Paperen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1547-5271&volume=2&spage=S166&epage=&date=2005&atitle=Incremental+benefit+of+rate+adaptive+pacing+onexercise+performance+during+cardiac+resynchronization+therapy.en_HK
dc.identifier.emailTse, HF: hftse@hkucc.hku.hken_HK
dc.identifier.emailLee, KLF: klflee@HKUCC.hku.hken_HK
dc.identifier.emailTsang, VYC: vyctsang@HKUCC.hku.hken_HK
dc.identifier.emailLau, CP: cplau@hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.identifier.doi10.1016/j.hrthm.2005.02.520-
dc.identifier.hkuros100897en_HK
dc.identifier.volume2en_HK
dc.identifier.spageS166, abstract no. P2-101en_HK
dc.identifier.epageS167-

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