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Physiological pacing improves symptoms and increases exercise capacity in the elderly patient
1Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, UK.
International Journal of Cardiology
|September 1, 1994
Summary
Physiological pacing significantly improves exercise tolerance and daily living symptoms in elderly patients with heart block. Age is not a barrier to beneficial physiological pacing systems.
Area of Science:
- Cardiology
- Geriatrics
- Biomedical Engineering
Background:
- Elderly patients often require cardiac pacing for heart block.
- Physiological pacing aims to mimic natural heart function, unlike traditional ventricular pacing.
Purpose of the Study:
- To evaluate the benefits of atrioventricular synchronous (physiological) pacing versus ventricular pacing in elderly individuals (>75 years).
- To compare exercise capacity and symptom burden between the two pacing modes.
Main Methods:
- A double-blind, crossover study involving 13 elderly patients with complete or Mobitz II heart block.
- Exercise capacity was assessed using a 6-minute walking test and stair climbing.
- Symptom severity was evaluated using an activities of daily living questionnaire.
Main Results:
- Patients walked significantly farther during the 6-minute walking test with physiological pacing (360m vs. 327m; P < 0.01).
- No significant difference was observed in stair climbing ability.
- Symptom scores markedly improved with physiological pacing (19 vs. 28; P < 0.01).
Conclusions:
- Physiological pacing enhances exercise tolerance and alleviates symptoms in the elderly population.
- Chronological age should not preclude the use of physiological pacing systems in older adults.