Heart failure with LVEF <40% was present in 31% of chronically paced patients, with higher prevalence in those with single-chamber versus dual-chamber pacemakers (35% vs 18%, p<0.008).
Cross-Sectional (n=307)
Heart failure due to left ventricular systolic dysfunction is highly prevalent (31%) in chronically paced patients, particularly those with single-chamber devices or chronic atrial fibrillation, suggesting a need for routine echocardiographic screening.
Absolute Event Rate: 35% vs 18%
p-value: p=<0.008
AIMS: To assess the prevalence of heart failure and asymptomatic left ventricular systolic dysfunction in the chronically paced population. METHODS AND RESULTS: Three hundred and seven patients were identified from attendance at routine pacemaker follow-up clinic. Subjects underwent a medical history and examination, 6-minute walk test and echocardiography. 94 (31%) had a left ventricular ejection fraction (LVEF) <40%, of whom 83 had symptoms of heart failure (70% NYHA II, 26% NYHA III and 4% NYHA IV). Heart failure was more prevalent in patients with single chamber compared to dual chamber pacemakers, (DDD(R) 18% vs 35% VVI(R), p<0.008), and those with chronic atrial fibrillation (AF) compared to those with sinus rhythm (42% vs 21%, p=0.003). Decreasing 6-minute walk distance, history of ischaemic heart disease and years of pacing were independently associated with the presence of heart failure (combined R=0.572, p<0.001). CONCLUSIONS: Heart failure due to left ventricular systolic dysfunction is common in the paced population. Only a minority of these had a pre-existing diagnosis and a smaller proportion were on 'optimal' therapy. Echocardiographic screening of this high-risk population is justified to improve rates of diagnosis and treatment of heart failure.
Simon Thackray (2003) conducted a cross-sectional in Chronically paced population (n=307). Single chamber pacemakers (VVI) vs. Dual chamber pacemakers (DDD) was evaluated on Prevalence of heart failure (p=<0.008). Heart failure with LVEF <40% was present in 31% of chronically paced patients, with higher prevalence in those with single-chamber versus dual-chamber pacemakers (35% vs 18%, p<0.008).