Cardiac Resynchronization Therapy Improves Heart Rate Variability in Patients with Symptomatic Heart Failure
Open Access
- 22 July 2003
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 108 (3), 266-269
- https://doi.org/10.1161/01.cir.0000083368.75831.7a
Abstract
Background— Cardiac resynchronization therapy (CRT) using biventricular pacing improves symptoms and functional capacity in patients with moderate to severe heart failure. The present study examined whether an improvement in ventricular performance from resynchronization therapy changes the autonomic control of heart rate. Methods and Results— Heart rate variability (HRV) was examined in 50 patients implanted with the InSync biventricular pacing system who were randomized to therapy-on (n=25) or therapy-off (n=25). HRV was computed as the standard deviation of the atrial cycle length sensed from the system over 2 months of continuous monitoring. HRV was compared between CRT-on and CRT-off groups. HRV was higher in patients randomized to CRT-on compared with CRT-off (148±47 ms for CRT-on versus 118±45 ms for CRT-off; P =0.02), despite the lack of difference in mean atrial cycle length (844±129 ms for CRT-on versus 851±110 ms for CRT-off; P =0.82). Changes in plasma catecholamines were not different between the CRT-on and CRT-off groups from baseline to the 3-month follow-up. Conclusions— Improvement in ventricular performance from CRT shifts cardiac autonomic balance toward a more favorable profile that is less dependent on sympathetic activation.This publication has 10 references indexed in Scilit:
- Short-Term Heart Rate Variability Strongly Predicts Sudden Cardiac Death in Chronic Heart Failure PatientsCirculation, 2003
- Cardiac Resynchronization in Chronic Heart FailureThe New England Journal of Medicine, 2002
- Effects of resynchronization therapy on sympathetic activity in patients with depressed ejection fraction and intraventricular conduction delay due to ischemic or idiopathic dilated cardiomyopathyThe American Journal of Cardiology, 2002
- β-Blocker Therapy in Heart FailureJAMA, 2002
- Independent and incremental prognostic value of heart rate variability in patients with chronic heart failureAmerican Heart Journal, 1999
- Detection and significance of a discrete very low frequency rhythm in RR interval variability in chronic congestive heart failureThe American Journal of Cardiology, 1996
- Relation of neurohumoral activation to clinical variables and degree of ventricular dysfunction: A report from the registry of studies of left ventricular dysfunctionJournal of the American College of Cardiology, 1994
- Components of heart rate variability — what they really mean and what we really measureThe American Journal of Cardiology, 1993
- The neurohormonal hypothesis: A theory to explain the mechanism of disease progression in heart failureJournal of the American College of Cardiology, 1992
- Plasma Norepinephrine as a Guide to Prognosis in Patients with Chronic Congestive Heart FailureThe New England Journal of Medicine, 1984