open access

Vol 64, No 9 (2006)
Other
Published online: 2006-10-11
Submitted: 2012-12-28
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Original article
Biventricular pacing demonstrates similar effects in elderly and younger patients with advanced heart failure in the mid-term follow-up

Ewa Lewicka-Nowak, Alicja Dąbrowska-Kugacka, Anna Faran, Andrzej Kutarski, Rajmund Wilczek, Grażyna Świątecka, Grzegorz Raczak
Kardiol Pol 2006;64(9):975-983.

open access

Vol 64, No 9 (2006)
Other
Published online: 2006-10-11
Submitted: 2012-12-28

Abstract

Background: Biventricular (BIV) pacing has been shown to improve haemodynamics and functional status of patients (pts) with advanced chronic heart failure (CHF). No study has determined the effects of BIV in relation to the age of pts. Aim: To compare the clinical outcome in two groups of pts: ≥65 years (yrs) and <65 yrs referred for BIV pacing in our centre with at least 6 months of follow-up. Methods: Among 15 pts ≥65 yrs and 16 pts <65 yrs successfully implanted with a BIV pacemaker, 12 and 15 pts, respectively, completed 6-month follow-up. Evaluation included change of NYHA class, 6-minute walking distance (6-minWD), drug therapy, QRS duration and echocardiographic parameters. The need for hospitalisation due to the worsening of CHF symptoms, assessed 6 months before and 6 months after BIV pacing, was compared. During long-term follow-up survival and complications related to this therapy were analysed. Results: In both groups after 6 months of BIV pacing clinical improvement was observed, as demonstrated by the reduction in NYHA class (p <0.005), average duration of hospitalisation due to CHF (p <0.05) and diuretics doses (p <0.05). The comparison of changes in these parameters between the two groups, as well as of changes in 6-minWD and echocardiographic parameters, did not show significant difference. BIV pacing enabled an increase in the dosage of beta-blockers (in 50% pts ≥65 yrs and 60% pts <65 yrs), as well as of ACEI or ARB (25% and 40% pts, respectively). Survival was 80% in 15 pts ≥65 yrs during 16±15 months of follow-up and 81% in 16 pts <65 yrs during 22±14 months. All complications occurred in the 30-day post-operative period with similar frequency in both groups, also when LV lead-related complications were compared. Conclusions: In the mid-term follow-up BIV pacing demonstrates similar improvement in clinical status and exercise tolerance in elderly pts ≥65 yrs, as compared with pts <65 yrs. In both groups BIV pacing reduced the need for hospitalisation due to worsening of CHF symptoms, and enabled beneficial changes in the pharmacological treatment. Elderly patients are not at risk of more frequent complications associated with BIV pacing.

Abstract

Background: Biventricular (BIV) pacing has been shown to improve haemodynamics and functional status of patients (pts) with advanced chronic heart failure (CHF). No study has determined the effects of BIV in relation to the age of pts. Aim: To compare the clinical outcome in two groups of pts: ≥65 years (yrs) and <65 yrs referred for BIV pacing in our centre with at least 6 months of follow-up. Methods: Among 15 pts ≥65 yrs and 16 pts <65 yrs successfully implanted with a BIV pacemaker, 12 and 15 pts, respectively, completed 6-month follow-up. Evaluation included change of NYHA class, 6-minute walking distance (6-minWD), drug therapy, QRS duration and echocardiographic parameters. The need for hospitalisation due to the worsening of CHF symptoms, assessed 6 months before and 6 months after BIV pacing, was compared. During long-term follow-up survival and complications related to this therapy were analysed. Results: In both groups after 6 months of BIV pacing clinical improvement was observed, as demonstrated by the reduction in NYHA class (p <0.005), average duration of hospitalisation due to CHF (p <0.05) and diuretics doses (p <0.05). The comparison of changes in these parameters between the two groups, as well as of changes in 6-minWD and echocardiographic parameters, did not show significant difference. BIV pacing enabled an increase in the dosage of beta-blockers (in 50% pts ≥65 yrs and 60% pts <65 yrs), as well as of ACEI or ARB (25% and 40% pts, respectively). Survival was 80% in 15 pts ≥65 yrs during 16±15 months of follow-up and 81% in 16 pts <65 yrs during 22±14 months. All complications occurred in the 30-day post-operative period with similar frequency in both groups, also when LV lead-related complications were compared. Conclusions: In the mid-term follow-up BIV pacing demonstrates similar improvement in clinical status and exercise tolerance in elderly pts ≥65 yrs, as compared with pts <65 yrs. In both groups BIV pacing reduced the need for hospitalisation due to worsening of CHF symptoms, and enabled beneficial changes in the pharmacological treatment. Elderly patients are not at risk of more frequent complications associated with BIV pacing.
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Keywords

heart failure; cardiac resynchronisation therapy; biventricular pacing

About this article
Title

Original article
Biventricular pacing demonstrates similar effects in elderly and younger patients with advanced heart failure in the mid-term follow-up

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 9 (2006)

Pages

975-983

Published online

2006-10-11

Bibliographic record

Kardiol Pol 2006;64(9):975-983.

Keywords

heart failure
cardiac resynchronisation therapy
biventricular pacing

Authors

Ewa Lewicka-Nowak
Alicja Dąbrowska-Kugacka
Anna Faran
Andrzej Kutarski
Rajmund Wilczek
Grażyna Świątecka
Grzegorz Raczak

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