Significant improvement of quality of life following atrioventricular synchronous pacing in patients with hypertrophic obstructive cardiomyopathy. Data from 1 year of follow-up. PIC study group. Pacing In Cardiomyopathy

Details

Serval ID
serval:BIB_8288AEF7ACCB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Significant improvement of quality of life following atrioventricular synchronous pacing in patients with hypertrophic obstructive cardiomyopathy. Data from 1 year of follow-up. PIC study group. Pacing In Cardiomyopathy
Journal
European Heart Journal
Author(s)
Gadler  F., Linde  C., Daubert  C., McKenna  W., Meisel  E., Aliot  E., Chojnowska  L., Guize  L., Gras  D., Jeanrenaud  X., Kappenberger  L.
ISSN
0195-668X (Print)
Publication state
Published
Issued date
07/1999
Volume
20
Number
14
Pages
1044-50
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jul
Abstract
AIMS: Atrioventricular synchronous pacing exerts beneficial effects, including reduction of left ventricular outflow tract gradients, in patients with hypertrophic obstructive cardiomyopathy. The Pacing in Cardiomyopathy study was initiated to explore the effects of pacing in a double-blind randomized crossover fashion. The aims were to ascertain the beneficial effects of pacing in a controlled study and to rule out a placebo effect by pacing. This paper deals with the outcome of pacing on quality of life during 1 year of follow-up. METHODS: Quality of life was evaluated with the Karolinska questionnaire, validated for patients paced for bradyarrhythmias and ischaemic heart disease. Drug-refractory patients with hypertrophic obstructive cardiomyopathy were recruited for the study and after a temporary pacing procedure implanted with permanent pacemakers. Patients were randomized to two study arms defining the sequence of pacemaker programming. In one arm the pacemaker was inactive, in the other active. After 3 months the pacemaker was reprogrammed to the alternate mode and a further 3 months followed. After this period subsequent pacemaker programming corresponded to the mode preferred by the patient. A last assessment was made 1 year after baseline examinations. RESULTS: Eighty patients completed the first crossover period and 75 completed the full 1 year of follow-up. Active pacing induced significant quality of life improvements, in the order of 9-44%, regardless of programming sequence. Discontinuation of pacing after a first active period resulted in the return of symptoms. Fourteen patients requested early reprogramming after having been programmed to inactive pacing after a first period of active pacing. Seventy-six patients preferred active pacing after the crossover period. A further 6 months of pacing induced progressive improvement in symptoms already favourably influenced. CONCLUSION: Atrioventricular synchronous pacing has a profound beneficial effect on most domains of quality of life in patients with hypertrophic obstructive cardiomyopathy refractory to drug treatment.
Keywords
Adult Aged Aged, 80 and over *Cardiac Pacing, Artificial Cardiomyopathy, Hypertrophic/*therapy Double-Blind Method Female Follow-Up Studies Humans Male Middle Aged *Quality of Life Randomized Controlled Trials
Pubmed
Web of science
Open Access
Yes
Create date
15/02/2008 11:28
Last modification date
20/08/2019 14:42
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