September 1, 2008Open Access
View Full PaperDevice-Guided Paced Breathing in the Home Setting
Key Result
Device-guided paced breathing at home for 10 weeks significantly improved ejection fraction, pulmonary pressure, NYHA class, and quality of life in patients with chronic heart failure (all P<0.05).
Study Design
Type
RCT (n=24)
Blinding
Open-label
Randomization
randomized
Structured PICO
Does device-guided paced breathing improve echocardiographic, pulmonary, and quality of life parameters in patients with chronic heart failure?
P
Population
24 patients with chronic heart failure and systolic dysfunction, mean age 64+/-9 years, 61% males, NYHA class 2.81+/-0.01.
I
Intervention
Device-guided paced breathing (using a computerized box connected to a respiration sensor and headphones to slow breathing rate <10 breaths/min) for 18 minutes twice daily, added to conventional treatment for 10 weeks.
C
Comparator
Conventional treatment alone.
O
Outcome
Changes in Doppler echocardiography, pulmonary function, cardiopulmonary stress test, and quality of life (Minnesota Quality of Life questionnaire) at 10 weeks.surrogate
Device-guided paced breathing at home is feasible and improves echocardiographic parameters, pulmonary function, and quality of life in patients with chronic heart failure.
Main Result
p-value: p=<0.05
Abstract
BACKGROUND: Regular slow breathing is known to improve autonomic cardiac regulation and reduce chemoreflex sensitivity in heart failure. We explored the acceptability and usefulness of a device for paced slow breathing at the home setting. METHODS AND RESULTS: In this open pilot study, 24 patients with chronic heart failure (61% males, mean age, 64+/-9 years; New York Heart Association class, 2.81+/-0.01) were randomized to a control group receiving conventional treatment (n=12) or to a group receiving conventional treatment and device-guided paced breathing (n=12). Groups were comparable for age, therapies, and clinical characteristics. They were evaluated at baseline and again after 10 weeks by Doppler echocardiography, pulmonary function, cardiopulmonary stress test, and quality of life (Minnesota Quality of Life questionnaire). The treatment group was instructed to use the equipment for 18 minutes twice daily. The device is a computerized box connected to a belt-type respiration sensor and to headphones; it generates musical tones (based on the user's breathing rate and inspiration ratio), which guide the user to progressively and effortlessly slow his or her breathing rate <10 breaths/min. The treatment group showed high compliance to the device (90% of the prescribed sessions were completed). Blinded analysis of data demonstrated increased ejection fraction and decreased estimated pulmonary pressure in the echocardiograms of the treated group versus controls and favorable changes in New York Heart Association class, Ve/Vco(2), FEV(1), and a quality of life measure, as well (all P<0.05). CONCLUSIONS: This pilot investigation demonstrates that device-guided paced breathing at home is feasible and results in an improvement in clinically relevant parameters for patients with heart failure and systolic dysfunction.