Cardiac resynchronization therapy: a pilot study examining cognitive change in patients before and after treatment.
BACKGROUND
Cardiovascular patients with reduced cardiovascular output and capacity such as those with congestive heart failure (CHF) have demonstrated cognitive-related dysfunction. The use of cardiac resynchronization therapy (CRT) is considered standard care for CHF patients who do not improve despite optimal medical therapy. Cardiac resynchronization therapy may improve neurocognitive and psychosocial functioning in patients by increasing cardiac output and cerebral perfusion.


METHODS
A total of 20 patients were examined before and 3 months after CRT device implantation, via administration of standard neurocognitive and psychosocial testing measures.


RESULTS
Significant improvements in neurocognitive measures of attention (Digit Span: t[20] = - 2.695 [55.94+/-9.27-62.31+/-10.05], P = 0.015) and information processing (Digit Symbol: t[20] = - 4.577, P < 0.001; Controlled Oral Word Association Test: t[20] = - 3.338, P = 0.004) were demonstrated. Improvements in cardiac-specific quality of life were also significant (Minnesota Living with Heart Failure Questionnaire: t[16] = 3.544, P = 0.005 [55.17+/-18.23-36.75+/-18.00]; The Left Ventricular Dysfunction Questionnaire: t[16] = 3.544, P = 0.003 [63.43+/-23.35-43.29+/-21.62]).


CONCLUSIONS
These results represent clinically significant, qualitative, and quantitative cognitive functional benefits for patients from a neurocognitive and psychosocial perspective. Results suggest that biventricular pacing improves cardiovascular outcome and psychosocial functioning in patients with CHF. The future investigation of a larger sample would be beneficial in establishing the depth and breadth of this improvement.
Dixit
Neha K
NK
NF/SG Veterans Health System, Department of Psychology, Gainesville, Florida, USA.
Vazquez
Lauren D
LD
Cross
Natalie J
NJ
Kuhl
Emily A
EA
Serber
Eva R
ER
Kovacs
Adrienne
A
Dede
Duane E
DE
Conti
Jamie B
JB
Sears
Samuel F
SF
D000328:Adult; D000368:Aged; D001288:Attention; D002302:Cardiac Output; D002304:Cardiac Pacing, Artificial; D002560:Cerebrovascular Circulation; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D056344:Executive Function; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*