Pacemaker therapy that boosts impaired heart rate response to exertion failed to improve exercise capacity or quality of life in patients with HFpEF in a small randomized trial.
The findings don't necessarily"slam the door shut" but do cast doubt on pacing therapy's prospects for improving"subjective or objective" exercise tolerance in patients with HFpEF like those in the trial, Borlaug said in discussion following his presentation.
RAPID-HF and the recent study to which Borlaug referred, called myPACE,"are complementary to help refine the optimal pacing strategy for HFpEF," Markus Meyer, MD, PhD, told theheart.org | Medscape Cardiology. RAPID-HF randomized 29 patients with HFpEF, defined here by an ejection fraction ≥ 40%, in New York Heart Association functional class 2-3, and in sinus rhythm with CI but no atrioventricular block. Those on beta-blockers continued to take them as prescribed.
Despite no change in cardiac output, mean stroke volume dropped by 24 mL in an exploratory analysis. The study, write Kitzman and associates, may help the field"embrace the broader pathophysiology of exercise intolerance in HFpEF" beyond a focus on cardiac dysfunction.
France Dernières Nouvelles, France Actualités
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