February 1, 1997Pacing and Clinical Electrophysiology
Acute Hemodynamic Improvement by Pacing in Patients with Severe Congestive Heart Failure
Key result
Individually optimized ventricular pacing without atrial pacing acutely improved hemodynamics in CHF patients, yielding an 8% increase in pulse pressure versus a 5% decrease with atrial pacing (P=0.01).
Why the study?
Does individually optimized ventricular pacing improve acute hemodynamics compared to sinus rhythm in patients with severe congestive heart failure?
Population
9 patients with severe congestive heart failure (NYHA Class II-III to Class IV)
Comparison
Acute pacing of the right, left, or both… vs Sinus rhythm (baseline)
Design
Case_series
Follow-up
acute
Authors
Discussion
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Member takes
Implication
May support testing optimized ventricular pacing in severe CHF; case-report data leave open whether acute gains improve outcomes.
Structured PICO
Does individually optimized ventricular pacing improve acute hemodynamics compared to sinus rhythm in patients with severe congestive heart failure?
P
Population
9 patients with severe congestive heart failure (NYHA Class II-III to Class IV)
I
Intervention
Acute pacing of the right, left, or both ventricles with individually optimized atrioventricular delay
C
Comparator
Sinus rhythm (baseline)
O
Outcome
Acute hemodynamic changes (mean pulse pressure, maximum aortic pulse pressure, and filling patterns)surrogate
Main Result
Absolute Event Rate: 8% vs -5%
p-value: p=0.01
Individually optimized ventricular pacing acutely improves hemodynamics in severe heart failure, with atrial-sensed modes outperforming atrial pacing when a functional sinus node is present.
Cite This Study
Auricchio et al. (1997) studied Severe Congestive Heart Failure (n=9). Individually optimized ventricular pacing (RV, LV, or biventricular) vs. Sinus rhythm or atrial pacing was evaluated on Maximum aortic pulse pressure change from sinus rhythm (p=0.01). Individually optimized ventricular pacing without atrial pacing acutely improved hemodynamics in CHF patients, yielding an 8% increase in pulse pressure versus a 5% decrease with atrial pacing (P=0.01).