on July 14, 2003
Published online before print July 14, 2003, doi: 10.1161/01.CIR.0000083368.75831.7A
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on September 18, 2002
From the Departments of Medicine, Cardiology, and Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla (P.B.A.); Medtronic, Inc, Minneapolis, Minn (K.J.K., W.L.V., S.S.); and the Department of Medicine, Cardiology, The Ohio State University, Columbus, Ohio (W.T.A.). * To whom correspondence should be addressed. E-mail: philip-adamson{at}OUHSC.edu.
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.
Revised on June 9, 2003
Accepted on June 10, 2003
Cardiac Resynchronization Therapy Improves Heart Rate Variability in Patients with Symptomatic Heart Failure
Philip B. Adamson MD*,
Key words: heart failure • pacing • heart rate • nervous system, autonomic
This article has been cited by other articles:
 |
|
 |
|
  J. P. Singh, L. S. Rosenthal, P. M. Hranitzky, K. C. Berg, C. M. Mullin, L. Thackeray, and A. Kaplan Device diagnostics and long-term clinical outcome in patients receiving cardiac resynchronization therapy Europace, December 1, 2009; 11(12): 1647 - 1653. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Auricchio Is it time to start with device-based prognosticators? Europace, October 6, 2009; (2009) eup291v1. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Landolina, M. Gasparini, M. Lunati, M. Santini, R. Rordorf, A. Vincenti, P. Diotallevi, A. S. Montenero, C. Bonanno, T. De Santo, et al. Heart rate variability monitored by the implanted device predicts response to CRT and long-term clinical outcome in patients with advanced heart failure Eur J Heart Fail, November 1, 2008; 10(11): 1073 - 1079. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Braunschweig, I. Ford, V. Conraads, M. R. Cowie, G. Jondeau, J. Kautzner, M. Lunati, R. M. Aguilera, C. M. Yu, M. Marijianowski, et al. Can monitoring of intrathoracic impedance reduce morbidity and mortality in patients with chronic heart failure? Rationale and design of the Diagnostic Outcome Trial in Heart Failure (DOT-HF) Eur J Heart Fail, September 1, 2008; 10(9): 907 - 916. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. G. J. Gademan, R. J. van Bommel, C. Ypenburg, J. C. W. Haest, M. J. Schalij, E. E. van der Wall, J. J. Bax, and C. A. Swenne Biventricular pacing in chronic heart failure acutely facilitates the arterial baroreflex Am J Physiol Heart Circ Physiol, August 1, 2008; 295(2): H755 - H760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Ferreira, P. Adragao, D. M. Cavaco, R. Candeias, F. B. Morgado, K. R. Santos, E. Santos, and J. A. Silva Benefit of cardiac resynchronization therapy in atrial fibrillation patients vs. patients in sinus rhythm: the role of atrioventricular junction ablation Europace, July 1, 2008; 10(7): 809 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. K. Lahiri, P. J. Kannankeril, and J. J. Goldberger Assessment of Autonomic Function in Cardiovascular Disease: Physiological Basis and Prognostic Implications J. Am. Coll. Cardiol., May 6, 2008; 51(18): 1725 - 1733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Burri, H. Sunthorn, A. Somsen, E. Fleury, C. Stettler, D. Shah, and A. Righetti Improvement in cardiac sympathetic nerve activity in responders to resynchronization therapy Europace, March 1, 2008; 10(3): 374 - 378. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Gould, G. Kong, V. Kalff, S. J. Duffy, A. J. Taylor, M. J. Kelly, and D. M. Kaye Improvement in cardiac adrenergic function post biventricular pacing for heart failure Europace, September 1, 2007; 9(9): 751 - 756. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. C. Hoppe, N. Freemantle, J. G.F. Cleland, M. Marijianowski, and E. Erdmann Effect of Cardiac Resynchronization on Morbidity and Mortality of Diabetic Patients With Severe Heart Failure Diabetes Care, March 1, 2007; 30(3): 722 - 724. [Full Text] [PDF]
|
|
|
|
|
|
F. Zannad, E. Huvelle, K. Dickstein, D. J. van Veldhuisen, C. Stellbrink, L. Kober, S. Cazeau, P. Ritter, A. P. Maggioni, R. Ferrari, et al. Left bundle branch block as a risk factor for progression to heart failure Eur J Heart Fail, January 1, 2007; 9(1): 7 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Najem, P. Unger, N. Preumont, J.-L. Jansens, A. Houssiere, A. Pathak, O. Xhaet, L. Gabriel, A. Friart, L. De Roy, et al. Sympathetic control after cardiac resynchronization therapy: responders versus nonresponders Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2647 - H2652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Piccirillo, D. Magri, S. di Carlo, T. De Laurentis, A. Torrini, S. Matera, M. Magnanti, L. Bernardi, F. Barilla, R. Quaglione, et al. Influence of cardiac-resynchronization therapy on heart rate and blood pressure variability: 1-year follow-up Eur J Heart Fail, November 1, 2006; 8(7): 716 - 722. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Parati, G. Mancia, M. D. Rienzo, P. Castiglioni, J. A. Taylor, and P. Studinger Point:Counterpoint: Cardiovascular variability is/is not an index of autonomic control of circulation J Appl Physiol, August 1, 2006; 101(2): 676 - 682. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. C. Hoppe, J. M. Casares, H. Eiskjaer, A. Hagemann, J. G.F. Cleland, N. Freemantle, and E. Erdmann Effect of Cardiac Resynchronization on the Incidence of Atrial Fibrillation in Patients With Severe Heart Failure Circulation, July 4, 2006; 114(1): 18 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Ermis and D. G. Benditt Cardiac resynchronization pacing without defibrillator capability: is this a viable option? Europace, July 1, 2006; 8(7): 499 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Vollmann, L. Luthje, P. Schott, G. Hasenfuss, and C. Unterberg-Buchwald Biventricular Pacing Improves the Blunted Force-Frequency Relation Present During Univentricular Pacing in Patients With Heart Failure and Conduction Delay Circulation, February 21, 2006; 113(7): 953 - 959. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Aranda Jr, G. W. Woo, R. S. Schofield, E. M. Handberg, J. A. Hill, A. B. Curtis, S. F. Sears, J. S. Goff, D. F. Pauly, and J. B. Conti Management of Heart Failure After Cardiac Resynchronization Therapy: Integrating Advanced Heart Failure Treatment With Optimal Device Function J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2193 - 2198. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Fantoni, S. Raffa, F. Regoli, F. Giraldi, M. T. La Rovere, J. Prentice, F. Pastori, S. Fratini, J. A. Salerno-Uriarte, H. U. Klein, et al. Cardiac Resynchronization Therapy Improves Heart Rate Profile and Heart Rate Variability of Patients With Moderate to Severe Heart Failure J. Am. Coll. Cardiol., November 15, 2005; 46(10): 1875 - 1882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Scheinman and E. Keung The year in clinical electrophysiology J. Am. Coll. Cardiol., March 1, 2005; 45(5): 790 - 795. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Grassi, A. Vincenti, R. Brambilla, F. Q. Trevano, R. Dell'Oro, A. Ciro, G. Trocino, A. Vincenzi, and G. Mancia Sustained Sympathoinhibitory Effects of Cardiac Resynchronization Therapy in Severe Heart Failure Hypertension, November 1, 2004; 44(5): 727 - 731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Adamson, A. L. Smith, W. T. Abraham, K. J. Kleckner, R. W. Stadler, A. Shih, M. M. Rhodes, and on behalf of the InSync III Model 8042 and Attain Continuous Autonomic Assessment in Patients With Symptomatic Heart Failure: Prognostic Value of Heart Rate Variability Measured by an Implanted Cardiac Resynchronization Device Circulation, October 19, 2004; 110(16): 2389 - 2394. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Adamson, W. T. Abraham, C. Love, and D. Reynolds The evolving challenge of chronic heart failure management: A call for a new curriculum for training heart failure specialists J. Am. Coll. Cardiol., October 6, 2004; 44(7): 1354 - 1357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Auricchio and W. T. Abraham Cardiac Resynchronization Therapy: Current State of the Art: Cost Versus Benefit Circulation, January 27, 2004; 109(3): 300 - 307. [Full Text] [PDF]
|
|