Pacemakers Have Beneficial Effects in Patients with Heart Failure

Reviewed by Elizabeth Klodas, MD, FACC

(CardioSmart--ESC Coverage) Patients with heart failure often display uncoordinated heart muscle contraction, which can worsen symptoms. Strategic heart muscle stimulation using pacemaker signals can help coordinate, or “resynchronize”, heart muscle squeezing activity. The use of pacemakers for this purpose is referred to as “cardiac resynchronization therapy” or CRT, and this therapy is usually reserved for patients with advanced heart failure and severe symptoms.

Investigators recently evaluated the effects of CRT in the setting of reduced heart function, but mild symptoms. 610 patients with pacemakers, low heart pumping capacity, and mild symptoms were randomized to either have the CRT function of their pacemaker turned on, or to have that capacity temporarily turned off. Both groups received optimal medical therapy. The average age of the patients was 63.

After a follow-up of 18 months, there was no significant difference between the two groups in terms of heart failure deaths. However, heart size decreased and pumping function improved significantly in the patients with CRT function on. And these individuals remained out of the hospital for a longer period of time, as compared to the group with the CRT function off.

The complete results of this study await publication. The above data was presented earlier this month at the European Society of Cardiology Congress, Munich, Germany. CRT is not appropriate for all patients with heart failure. Only those individuals who meet specific criteria appear to attain benefit. Please be sure to always discuss any treatment options for your heart with your cardiologist.

References:

Progressive Reverse Remodeling in Patients With Mild or Asymptomatic Heart Failure With Previous Symptoms: Results From the REVERSE Trial. Presented by Dr. Cecilia Linde at the European Society of Cardiology Congress, Munich, Germany, August/September 2008.

12-Month Results of the REVERSE Study. Presented by Dr. Cecilia Linde at the SCAI-ACC i2 Summit/American College of Cardiology Annual Scientific Session, Chicago, IL, March/April 2008.

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