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Articles linked to this work by shared authors, journal, and citation graph.

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Prevalence and incidence of left ventricular systolic dysfunction and adverse outcomes in patients receiving <i>de novo</i> and replacement pacemaker therapy for bradycardia.

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Personalised reprogramming to prevent progressive pacemaker-related left ventricular dysfunction: A phase II

Maria F Paton1,2, John Gierula1, Judith E Lowry1

  • 1Leeds Institute of Cardiovascular and Metabolic Medicine, Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, United Kingdom.

Plos One
|December 13, 2021
PubMed
Summary

Personalized pacemaker programming reduces right ventricular pacing, improving heart function and extending battery life. This approach is safe and effective for patients with pacemakers.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Clinical Trials

Background:

  • Right ventricular (RV) pacing, common in bradycardia treatment, increases risks of left ventricular (LV) dysfunction and heart failure.
  • Personalized pacemaker reprogramming aims to mitigate these risks by minimizing RV pacing.

Purpose of the Study:

  • To compare personalized pacemaker reprogramming versus usual care for echocardiographic and patient-centered outcomes.
  • To evaluate the impact on LV function, remodeling, quality of life, and battery longevity.

Main Methods:

  • A prospective, double-blind, randomized phase II trial involving 100 patients with pacemakers.
  • Personalized reprogramming followed a published protocol, with LV ejection fraction as the primary outcome after 6 months.

Main Results:

  • Personalized programming significantly reduced RV pacing compared to usual care (-6.5% vs -0.21%, p<0.01).
  • Improvements observed in LV ejection fraction (+3.09%, p=0.02) and LV end-systolic volume index (-2.99mL/m2, p=0.03).
  • Battery longevity increased by approximately 5 months (p<0.01) with no significant impact on quality of life.

Conclusions:

  • Personalized pacemaker programming is a safe and effective strategy for patients with bradycardia.
  • This approach improves LV function and dimensions while extending pacemaker battery life.