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Jan 16, 2014

Heart Failure Patients with Pacemakers Benefit from High-Dose Medication

Recent study identifies the best combination of therapies for heart failure patients after receiving a pacemaker.

Between debilitating symptoms and frequent trips to the hospital, severe heart failure can take a toll on quality of life. But according to a recent study, the right doses of medication may improve outcomes for certain heart failure patients.

Published in the European Heart Journal, this study included Swiss heart failure patients who received a pacemaker as treatment for their condition. For patients with moderate to severe heart failure, pacemaker implantation (called cardiac resynchronization therapy) can be useful for relieving symptoms and reducing hospital trips, thus improving outcomes and quality of life. And in this study, researchers attempted to determine whether a certain combination of therapies (high-dose medications and low-dose diuretics) improve outcomes after pacemaker implantation.

Between 2000 and 2010, researchers enrolled a total of 185 patients from a hospital in Zurich. While following patients for nearly four years, investigators tracked which medications each patient took and in what doses. Medications were considered standard for heart failure treatment and included ACE-I (angiotensin-converting enzyme inhibitors) or ARBs (angiotensin receptor blockers), plus beta-blockers and diuretics. During the follow-up period, researchers also took note of any serious complications from heart failure such as hospitalization, heart transplantation and death.

After analysis, researchers found that patients receiving higher doses of ACE-I or ARBs and beta-blockers and lower doses of diuretics had better outcomes. In other words, patients with this “ideal” combination of therapies had fewer health complications after receiving a pacemaker than those with other dose-combinations.

Authors hope to spark future research on the topic, as heart failure is especially common in older adults. More than 5 million Americans are living with heart failure and the more we know about the best available treatments, the better outcomes will be. Finding the perfect combination of therapies for heart failure patients can be a challenge, but with additional research, experts hope to continue to identify ideal therapies to improve quality of life and outcomes for patients with this chronic condition.

Questions for You to Consider

  • Who is at risk for heart failure?

  • Risk for heart failure increases with age, and is most common in patients with heart disease or other cardiovascular conditions, such as arrhythmia or history of heart attack. 

  • What are common heart failure symptoms?

  • Heart failure symptoms often present themselves slowly but progress and worsen over time. These symptoms include shortness of breath; swelling of feet, ankles or abdomen; fatigue; cough and weight gain.


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