Accelerated Pacing Improves Quality of Life in HFpEF Patients

TUESDAY, Feb. 7, 2023 (HealthDay News) -- Treatment with a moderately accelerated personalized backup pacing rate (myPACE) is beneficial for patients with stage B and C heart failure with preserved ejection fraction (HFpEF), according to a study published online Feb. 1 in JAMA Cardiology.

Margaret Infeld, M.D., from the University of Vermont Larner College of Medicine in Burlington, and colleagues examined the effects of a moderately accelerated personalized backup heart rate compared to 60 bpm (usual care) in a blinded trial involving patients with stage B and C HFpEF. Participants were randomly assigned to personalized accelerated pacing or usual care (50 and 57 patients, respectively) and were followed for one year.

The researchers found that the median pacemaker-detected heart rate was 75 and 65 bpm in the personalized accelerated pacing arm and usual care arm, respectively. There was an improvement in the Minnesota Living with Heart Failure Questionnaire scores in the personalized accelerated pacing group at one month and one year, while the usual care group had a worsening in scores. Improved changes were also seen in N-terminal pro-brain natriuretic peptide levels, activity levels, and device-detected atrial fibrillation in the personalized accelerated pacing group compared with usual care during follow-up of one year. Adverse clinical events occurred in four and 11 patients in the personalized accelerated pacing group and usual care group, respectively.

"The myPACE study supports the concept of heart rate modulation as a therapeutic intervention in HFpEF and provides additional evidence that moderately higher, and not lower, heart rates are beneficial in this complex patient population," the authors write.

Several authors disclosed ties to Medtronic, including one author who had a patent for pacemakers for HFpEF licensed to Medtronic.

Abstract/Full Text (subscription or payment may be required)