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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Reduced ejection fraction, sudden cardiac death, and heart failure death in the mode selection trial (MOST):

Michael O Sweeney1, Anne S Hellkamp, Kenneth A Ellenbogen

  • 1Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. mosweeney@partners.org

Journal of Cardiovascular Electrophysiology
|June 17, 2008
PubMed

Insights

Elderly pacemaker patients with reduced ejection fraction (EF

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Electrophysiology

Background:

  • Sudden cardiac death (SCD) and heart failure (HF) are significant concerns in elderly patients with pacemakers.
  • Sinus node disease (SND) is a common indication for pacemaker implantation in this demographic.
  • Understanding predictors of mortality is crucial for optimizing patient care.

Purpose of the Study:

  • To determine the incidence and predictors of SCD and HF death in elderly patients with SND treated with pacemakers.
  • To evaluate the proportion of patients meeting criteria for implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT).

Main Methods:

  • Analysis of 1,135 patients from the Mode Selection Trial, a 6-year study on pacing modes in SND.
  • Stratification of patients based on ejection fraction (EF): or= 50%.
  • Statistical analysis to identify predictors of SCD and HF death, including hazard ratios (HR) and confidence intervals (CI).

Main Results:

  • Reduced EF (
  • The 4-year SCD rate for patients with EF
  • Nearly 20% of patients qualified for ICDs, with over 40% dying within 33 months.

Conclusions:

  • Reduced ejection fraction is a key predictor of SCD and HF death in SND patients with pacemakers.
  • SCD rates in this group are similar to primary prevention ICD trial control arms, but overall mortality is higher.
  • Prospective studies are needed to assess the efficacy of ICDs or CRT in this high-risk elderly population.
Abstract

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