Comparison of permanent left ventricular and biventricular pacing in patients with heart failure and chronic atrial fibrillation: prospective haemodynamic study
Key result
Biventricular pacing provided better haemodynamic performance during exercise than left ventricular pacing, showing a greater increase in mean percentage variation of PEA (125% vs 97%; P=0.048).
Why the study?
Does biventricular pacing improve haemodynamic performance and exercise capacity compared to left ventricular pacing in patients with severe heart failure and chronic atrial fibrillation?
Population
13 patients with chronic atrial fibrillation, severe heart failure, and QRS prolongation of >= 140 ms who…
Comparison
Biventricular pacing for 2 months vs Left ventricular pacing for 2 months
Design
RCT, randomised study with crossover, random order, single blinded
Follow-up
2 months per pacing mode
Authors
Discussion
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Implication
Prioritize biventricular over left ventricular pacing for exercise performance in severe HF with chronic AF post-ablation; extends CRT evidence.
Study Design
Type
RCT (n=13)
Blinding
Single-blind
Randomization
Crossover
Multicenter
No
Structured PICO
Does biventricular pacing improve haemodynamic performance and exercise capacity compared to left ventricular pacing in patients with severe heart failure and chronic atrial fibrillation?
P
Population
13 patients with chronic atrial fibrillation, severe heart failure (mean ejection fraction 24%), and QRS prolongation of >= 140 ms who had His bundle ablation, mean age 62 years.
I
Intervention
Biventricular pacing for 2 months
C
Comparator
Left ventricular pacing for 2 months (crossover design)
O
Outcome
Clinical and haemodynamic variables (peak endocardial acceleration) during daily life and maximum exercisesurrogate
Main Result
Absolute Event Rate: 125% vs 97%
p-value: p=0.048
In patients with severe heart failure and chronic atrial fibrillation undergoing His bundle ablation, chronic biventricular pacing provides better haemodynamic and exercise performance than left ventricular pacing.
Cite This Study
Garrigue et al. (2002) conducted an RCT in Severe heart failure and chronic atrial fibrillation (n=13). Biventricular pacing vs. Left ventricular pacing was evaluated on Mean percentage variation of peak endocardial acceleration (PEA) on cardiopulmonary exercise testing (p=0.048). Biventricular pacing provided better haemodynamic performance during exercise than left ventricular pacing, showing a greater increase in mean percentage variation of PEA (125% vs 97%; P=0.048).