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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Changes in heart rate variability are correlated to hemodynamic improvement with chronic CARVEDILOL therapy in heart

John R Bullinga1, Rami Alharethi, Mark S Schram

  • 1Division of Cardiology, New York University, New York, NY, USA.

Journal of Cardiac Failure
|December 20, 2005
PubMed

Insights

Carvedilol significantly improved heart rate variability (HRV) in heart failure patients. This suggests carvedilol therapy helps normalize autonomic function and may improve cardiac hemodynamics.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Function

Background:

  • Reduced heart rate variability (HRV) is a predictor of mortality in congestive heart failure (CHF).
  • The link between enhanced cardiac function and HRV improvement in CHF was previously unstudied.

Purpose of the Study:

  • To investigate the effect of carvedilol on HRV in patients with CHF.
  • To determine if improvements in HRV correlate with changes in cardiac function.

Main Methods:

  • Substudy of a 4-month randomized, placebo-controlled, double-blind trial.
  • 24-hour Holter monitors analyzed HRV at baseline and study completion.
  • Participants had symptomatic CHF and left ventricular ejection fraction (LVEF) <0.35.

Main Results:

  • Carvedilol treatment significantly increased various HRV measures (total power, VLF, HF, SDNN, RMSSD, pNN50).
  • Improvements in HRV correlated positively with LVEF changes.
  • HRV changes negatively correlated with coronary sinus norepinephrine levels.

Conclusions:

  • Carvedilol therapy significantly enhanced HRV in CHF patients.
  • HRV changes correlated with improved hemodynamics.
  • Carvedilol appears to partially normalize autonomic modulation of heart rate in CHF.
Abstract

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