Dual chamber pacing with optimal AV delay in congestive heart failure: a randomized study.
OBJECTIVE
A prospective randomized trial was set up to evaluate contractile parameters and quality of life in patients with congestive heart failure.


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 effect 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.
Capucci
A
A
Civile Hospital, Piacenza, Italy.
Romano
S
S
Puglisi
A
A
Santini
M
M
Pagani
M
M
Cazzin
R
R
Zanuttini
D
D
Mangiameli
S
S
Moracchini
P V
PV
Neri
R
R
De Ciuceis
P
P
Circo
A
A
Cavaglià
S
S
De Seta
F
F
D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013997:Time Factors