Copyright © 2003 by the European Society of Cardiology.
Regular Articles
The prevalence of heart failure and asymptomatic left ventricular systolic dysfunction in a typical regional pacemaker population
Castle Hill Hospital, University of Hull, Hull UK
* Correspondence to: S D. R. Thackray, MRCP, Castle Hill Hospital, University of Hull, X-ray 3, Entrance 3, Cottingham, Hull HU16 5JQ, UK. Tel: +44-1482-624073; fax: +44-1482624071
E-mail address: simonthackray{at}hotmail.com
Received 6 November 2002; revised 21 January 2003; accepted 26 February 2003
Aims To assess the prevalence of heart failure and asymptomatic left ventricular systolic dysfunction in the chronically paced population.
Methods and Results Three hundred and seven patients were identified from attendance at routine pacemaker follow-up clinic. Subjects underwent a medical history and examination, 6-minute walk test and echocardiography. 94 (31%) had a left ventricular ejection fraction (LVEF) <40%, of whom 83 had symptoms of heart failure (70% NYHA II, 26% NYHA III and 4% NYHA IV). Heart failure was more prevalent in patients with single chamber compared to dual chamber pacemakers, (DDD(R) 18% vs 35% VVI(R), p<0.008), and those with chronic atrial fibrillation (AF) compared to those with sinus rhythm (42% vs 21%, p=0.003). Decreasing 6-minute walk distance, history of ischaemic heart disease and years of pacing were independently associated with the presence of heart failure (combined R=0.572, p<0.001).
Conclusions Heart failure due to left ventricular systolic dysfunction is common in the paced population. Only a minority of these had a pre-existing diagnosis and a smaller proportion were on ‘optimal’ therapy. Echocardiographic screening of this high-risk population is justified to improve rates of diagnosis and treatment of heart failure.
Key Words: Heart failure • Pacemakers • Pacemaker syndrome • Echocardiography
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. M Cubbon and K. K A Witte Cardiac resynchronisation therapy for chronic heart failure and conduction delay BMJ, April 28, 2009; 338(apr28_2): b1265 - b1265. [Full Text]
|
|
|
|
 |
|
 P. W.X. Foley, S. A. Muhyaldeen, S. Chalil, R. E.A. Smith, J. E. Sanderson, and F. Leyva Long-term effects of upgrading from right ventricular pacing to cardiac resynchronization therapy in patients with heart failure Europace, April 1, 2009; 11(4): 495 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G F Cleland, A. Tageldien, N. Maarouf, and N. Hobson Patients with heart failure who require an implantable defibrillator should have cardiac resynchronisation routinely Heart, August 1, 2008; 94(8): 963 - 966. [Full Text] [PDF]
|
|
|
|
|
|
A. Quesada, G. Botto, A. Erdogan, M. Kozak, P. Lercher, J. C. Nielsen, O. Piot, R. Ricci, C. Weiss, D. Becker, et al. Managed ventricular pacing vs. conventional dual-chamber pacing for elective replacements: the PreFER MVP study: clinical background, rationale, and design Europace, March 1, 2008; 10(3): 321 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Leclercq Upgrading from right ventricular pacing to biventricular pacing in pacemaker patients with chronic heart failure Heart, January 1, 2008; 94(1): 102 - 107. [Full Text] [PDF]
|
|
|
|
|
|
C. Raphael, C. Briscoe, J. Davies, Z. Ian Whinnett, C. Manisty, R. Sutton, J. Mayet, and D. P Francis Limitations of the New York Heart Association functional classification system and self-reported walking distances in chronic heart failure Heart, April 1, 2007; 93(4): 476 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-F. Tse and C.-P. Lau Selection of Permanent Ventricular Pacing Site: How Far Should We Go? J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1649 - 1651. [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Shelton, A. L. Clark, K. Goode, A. S. Rigby, and J. G.F. Cleland The diagnostic utility of N-terminal pro-B-type natriuretic peptide for the detection of major structural heart disease in patients with atrial fibrillation Eur. Heart J., October 1, 2006; 27(19): 2353 - 2361. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. D.R. Thackray, G. A. Wright, K. K.A. Witte, N. P. Nikitin, A. C. Tweddel, A. L. Clark, and J. G.F. Cleland The effect of ventricular pacing on measurements of left ventricular function: A comparison between echocardiographic methods and with radionuclide ventriculography Eur J Echocardiogr, August 1, 2006; 7(4): 284 - 292. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Caro, A. Ward, and J. Moller Modelling the health benefits and economic implications of implanting dual-chamber vs. single-chamber ventricular pacemakers in the UK Europace, June 1, 2006; 8(6): 449 - 455. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kindermann, B. Hennen, J. Jung, J. Geisel, M. Bohm, and G. Frohlig Biventricular Versus Conventional Right Ventricular Stimulation for Patients With Standard Pacing Indication and Left Ventricular Dysfunction: The Homburg Biventricular Pacing Evaluation (HOBIPACE) J. Am. Coll. Cardiol., May 16, 2006; 47(10): 1927 - 1937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Lin, K. Connelly, and D. Prior An unusual cause of heart failure identified by echocardiography in an octogenarian Eur J Heart Fail, January 1, 2005; 7(1): 99 - 102. [Abstract] [Full Text] [PDF]
|
|