Effect of Personalized Accelerated Pacing on Quality of Life, Physical Activity, and Atrial Fibrillation in Patients With Preclinical and Overt Heart Failure With Preserved Ejection Fraction The myPACE Randomized Clinical Trial

This study aimed to assess the effects of a personalized, moderately accelerated backup heart rate compared to the standard rate of 60 beats per minute in patients with heart failure with preserved ejection fraction (HFpEF) who have preexisting pacemaker systems. The study enrolled 107 participants from the University of Vermont Medical Center pacemaker clinic and was a randomized, blinded clinical trial that lasted 1 year. Participants were randomly assigned to receive either personalized accelerated pacing or the standard rate of 60 beats per minute. The personalized heart rate was calculated based on a resting heart rate algorithm that was modified by the individual’s ejection fraction.

The primary outcome measured was the change in scores of the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and secondary outcomes included changes in N-terminal pro-brain natriuretic peptide levels, physical activity, atrial fibrillation, and adverse clinical events. The results showed that patients in the personalized accelerated pacing group had improved MLHFQ scores, as well as improved N-terminal pro-brain natriuretic peptide levels, physical activity, and fewer occurrences of atrial fibrillation compared to those in the standard care group. The personalized, accelerated pacing rate was found to be safe, with a lower number of adverse clinical events in this group compared to the standard care group.

Overall, the study found that using a personalized, moderately accelerated pacing rate was safe and improved quality of life, N-terminal pro-brain natriuretic peptide levels, physical activity, and atrial fibrillation compared to the standard rate of 60 beats per minute in patients with HFpEF and pacemakers.

 

doi:10.1001/jamacardio.2022.5320


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