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European Heart Journal 1989 10(1):63-69;
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

The relationship of symptoms to performance in paced patients with breathlessness

A. ROZKOVEC*,, M. PAPOUCHADO*, M. A. JAMES*, A. H. KENDRICK{dagger}, L. M. CLARKE* and J. RUSSELL REES*

*Cardiology Bristol Avon BS2 8HW U.K.
{dagger}Respiratory Departments, Bristol Royal Infirmary Bristol Avon BS2 8HW U.K.

Received 28 August 1987; revised 13 July 1988; .

Address for correspondence- Dr A. Rozkovec, Cardiac Department, Royal Victoria Hospital, Boscombe, Bournemouth, BH1 4JG, U.K

Abstract

Eighteen adult patients presenting with breathlessness associated with bradycardia, and whose breathlessness was diminished or abolished by permanent pacing, were studied at least one month after this procedure in order to examine the relationship between symptoms and exercise performance. All were pacing-dependent at rest and were studied over successive two-weekly periods at set rates of 50, 70 and 90 beats min-1 in a double-blind, balanced and randomized trial. The degree of breathlessness was closely related to exercise capacity judged by 6-min walk testing, effort scores and weekly pedometer distance. Overall results were worse at 50 beats min-1 than the two faster rates. For a given individual, changing of ventricular rate caused parallel alterations in symptoms and performance.

The 6-min walking test was a useful guide to disability in these patients, tightly linked to the symptoms of effort and breathlessness, and may be of clinical value in assessing mild heart failure. The pedometer readings were influenced more by the patients' walking habits than by fitness.

Key Words: Dyspnoea • exercise test • heart function tests • heart rate • congestive heart failure


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