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Europace 1999 1(3):174-178; doi:10.1053/eupc.1999.0034
© 1999 by European Society of Cardiology
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Dual chamber pacing with optimal AV delay in congestive heart failure

A randomized study

A. Capucci*, S. Romano{dagger}, A. Puglisi{ddagger}, M. Santini§, M. Pagani||, R. Cazzin, D. Zanuttini**, S. Mangiameli{dagger}{dagger}, P.V. Moracchini{ddagger}{ddagger}, R. Neri§§, P. De Ciuceis||||, A. Circo¶¶, S. Cavaglià*** and F. De Seta***

*Civile Hospital Piacenza, Italy; {dagger}Maggiore Hospital IRCCS Milano, Italy; {ddagger}Fatebenefratelli Hospital Isola Tiberina Roma, Italy; §S. Filippo Neri Hosptial Roma, Italy; ||Civile Hospital Legnano, Italy; Civile Hospital Portogruaro, Italy; **Civile Hospital Pordenone, Italy; {dagger}{dagger}Garibaldi Hospital Catania, Italy; {ddagger}{ddagger}S. Agostino Hospital Modena, Italy; §§G.B. Grassi Hospital Ostia, Italy; ||||Silvestrini Hospital Perugia, Italy; ¶¶S. Luigi Gonzaga Hospital Catania, Italy; ***Medtronic Italia SpA Roma, Italy

AIM: A prospective randomized trial was set up to evaluate contractile parameters and quality of life in patients with congestive heart failure.

METHODS AND RESULTS: We describe the results from 38 patients in sinus rhythm and with chronic heart failure due to congestive cardiomyopathy, prospectively randomized to optimal medical therapy (Group 1, 19 patients) or optimal medical therapy plus dual chamber pacemaker programmed to optimal AV delay (Group 2, 19 patients).

At a 6 month follow-up, 7/19 patients in Group 1 had died compared with 5/19 patients in Group 2. During follow-up, there were few significant changes in evaluated parameters except for mitral regurgitation time, which was prolonged in Group 1 and shortened in Group 2. The systolic left ventricular diameter shortened significantly only in Group 2. An energy and activity questionnaire showed that the eVect of DDD pacing in the latter patient population was beneficial.

CONCLUSIONS: From these results we may conclude that at the 6 month follow-up DDD pacing with echo-optimized AV interval programming can improve quality of life without affecting survival.

Key Words: Congestive heart failure, dilated cardiomyopathy, dual chamber pacing

Correspondence: Dr A. Capucci, Ospedale Civile Cardiology Department, Via Taverna 49, 29100 Piacenza, Italy.


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