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Article: The incremental benefit of rate-adaptive pacing on exercise performance during cardiac resynchronization therapy

TitleThe incremental 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/jac
Citation
Journal Of The American College Of Cardiology, 2005, v. 46 n. 12, p. 2292-2297 How to Cite?
AbstractOBJECTIVES: The purpose of this research was to investigate the effect of using rate-adaptive pacing and atrioventricular interval (AVI) adaptation on exercise performance during cardiac resynchronization therapy (CRT). BACKGROUND: The potential incremental benefits of using rate-adaptive pacing and AVI adaptation with CRT during exercise have not been studied. METHODS: We studied 20 patients with heart failure, chronotropic incompetence (<85% age-predicted heart rate [AP-HR] and <80% HR reserve), and implanted with CRT. All patients underwent a cardiopulmonary exercise treadmill test using DDD mode with fixed AVI (DDD-OFF), DDD mode with adaptive AVI on (DDD-ON), and DDDR mode with adaptive AVI on (DDDR-ON) to measure metabolic equivalents (METs) and peak oxygen consumption (Vo 2max). RESULTS: During DDD-OFF mode, not all patients reached 85% AP-HR during exercise, and 55% of patients had <70% AP-HR. Compared to patients with >70% AP-HR, patients with <70% AP-HR had significantly lower baseline HR (66 ± 3 beats/min vs. 80 ± 5 beats/min, p = 0.015) and percentage HR reserve (27 ± 5% vs. 48 ± 6%, p = 0.006). In patients with <70% AP-HR, DDDR-ON mode increased peak exercise HR, exercise time, METs, and Vo 2max compared with DDD-OFF and DDD-ON modes (p < 0.05), without a significant difference between DDD-OFF and DDD-ON modes. In contrast, there were no significant differences in peak exercise HR, exercise time, METs, and Vo 2max among the three pacing modes in patients with >70% AP-HR. The percentage HR changes during exercise positively correlated with exercise time (r = 0.67, p < 0.001), METs (r = 0.56, p < 0.001), and Vo 2max (r = 0.55, p < 0.001). CONCLUSIONS: In heart failure patients with severe chronotropic incompetence as defined by failure to achieve >70% AP-HR, appropriate use of rate-adaptive pacing with CRT provides incremental benefit on exercise capacity during exercise. © 2005 by the American College of Cardiology Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/76348
ISSN
2023 Impact Factor: 21.7
2023 SCImago Journal Rankings: 8.762
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorLee, KLFen_HK
dc.contributor.authorFan, Ken_HK
dc.contributor.authorChan, HWen_HK
dc.contributor.authorTang, MOen_HK
dc.contributor.authorTsang, Ven_HK
dc.contributor.authorLee, SWLen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-09-06T07:20:16Z-
dc.date.available2010-09-06T07:20:16Z-
dc.date.issued2005en_HK
dc.identifier.citationJournal Of The American College Of Cardiology, 2005, v. 46 n. 12, p. 2292-2297en_HK
dc.identifier.issn0735-1097en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76348-
dc.description.abstractOBJECTIVES: The purpose of this research was to investigate the effect of using rate-adaptive pacing and atrioventricular interval (AVI) adaptation on exercise performance during cardiac resynchronization therapy (CRT). BACKGROUND: The potential incremental benefits of using rate-adaptive pacing and AVI adaptation with CRT during exercise have not been studied. METHODS: We studied 20 patients with heart failure, chronotropic incompetence (<85% age-predicted heart rate [AP-HR] and <80% HR reserve), and implanted with CRT. All patients underwent a cardiopulmonary exercise treadmill test using DDD mode with fixed AVI (DDD-OFF), DDD mode with adaptive AVI on (DDD-ON), and DDDR mode with adaptive AVI on (DDDR-ON) to measure metabolic equivalents (METs) and peak oxygen consumption (Vo 2max). RESULTS: During DDD-OFF mode, not all patients reached 85% AP-HR during exercise, and 55% of patients had <70% AP-HR. Compared to patients with >70% AP-HR, patients with <70% AP-HR had significantly lower baseline HR (66 ± 3 beats/min vs. 80 ± 5 beats/min, p = 0.015) and percentage HR reserve (27 ± 5% vs. 48 ± 6%, p = 0.006). In patients with <70% AP-HR, DDDR-ON mode increased peak exercise HR, exercise time, METs, and Vo 2max compared with DDD-OFF and DDD-ON modes (p < 0.05), without a significant difference between DDD-OFF and DDD-ON modes. In contrast, there were no significant differences in peak exercise HR, exercise time, METs, and Vo 2max among the three pacing modes in patients with >70% AP-HR. The percentage HR changes during exercise positively correlated with exercise time (r = 0.67, p < 0.001), METs (r = 0.56, p < 0.001), and Vo 2max (r = 0.55, p < 0.001). CONCLUSIONS: In heart failure patients with severe chronotropic incompetence as defined by failure to achieve >70% AP-HR, appropriate use of rate-adaptive pacing with CRT provides incremental benefit on exercise capacity during exercise. © 2005 by the American College of Cardiology Foundation.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jacen_HK
dc.relation.ispartofJournal of the American College of Cardiologyen_HK
dc.rightsJournal of American College of Cardiology. Copyright © Elsevier Inc.en_HK
dc.subject.meshAdaptation, Physiologicalen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAlgorithmsen_HK
dc.subject.meshAtrioventricular Node - physiopathologyen_HK
dc.subject.meshCardiac Output, Low - physiopathology - therapyen_HK
dc.subject.meshCardiac Pacing, Artificial - methodsen_HK
dc.subject.meshExerciseen_HK
dc.subject.meshExercise Testen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHeart Rateen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.titleThe incremental benefit of rate-adaptive pacing on exercise performance during cardiac resynchronization therapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0735-1097&volume=46&issue=12&spage=2292&epage=7&date=2005&atitle=The+incremental+benefit+of+rate-adaptive+pacing+on+exercise+performance+during+cardiac+resynchronization+therapy.en_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jacc.2005.02.097en_HK
dc.identifier.pmid16360061en_HK
dc.identifier.scopuseid_2-s2.0-28944440880en_HK
dc.identifier.hkuros114952en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-28944440880&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume46en_HK
dc.identifier.issue12en_HK
dc.identifier.spage2292en_HK
dc.identifier.epage2297en_HK
dc.identifier.isiWOS:000234090600020-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridLee, KLF=7501505962en_HK
dc.identifier.scopusauthoridFan, K=7202978353en_HK
dc.identifier.scopusauthoridChan, HW=7403402419en_HK
dc.identifier.scopusauthoridTang, MO=7401973887en_HK
dc.identifier.scopusauthoridTsang, V=7005694255en_HK
dc.identifier.scopusauthoridLee, SWL=23990967700en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.issnl0735-1097-

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