Quality of Life in Patients with Rate Responsive Pacemakers: A Randomized, Cross‐Over Study

Abstract

Eleven patients with rate responsive pacemakers (7 men, 4 women, mean age 41 years with a range of 23-60) were randomly assigned to a cross-over study in order to assess their overall exercise capacity and quality-of-life (QOL) scores. All of the pacemakers were implanted for complete AV block or sick sinus syndrome. The pacemakers were randomly programmed into VVI or rate responsive (VVIR) pacing modes for 3-week study periods in each mode. At the end of each period, an exercise test was performed and the QOL was evaluated by the "Hacettepe Quality-of-Life Questionnaire". All patients exercised longer in the VVIR mode (mean 10.54 +/- 0.73 min) than in the VVI mode (mean 7.81 +/- 0.62 min) (P less than 0.05). QOL scores were also found to be significantly higher in the VVIR mode (mean 173.81 +/- 16.22 points) compared to the VVI mode (mean 156.27 +/- 21.22 points) (P less than 0.01). In conclusion, our results suggest that VVIR pacing offers a better QOL in addition to an improved exercise capacity, compared to the single chamber nonrate modulated pacing (VVI).

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

“…The benefit of rate response programming has been evaluated in patients with bradycardia in 5 multicenter, randomized trials and in 1 systematic review that also included 7 single-center studies [17][18][19][20][21][22]. Most of these data were obtained from pacemaker studies and must be interpreted in that light.…”

“…Patients with permanent AF and either spontaneous or AV junctional ablation-induced high-degree atrioventricular block have little to no chronotropic response to exercise; thus, VVIR pacing is associated with better exercise performance, improved daily activities, improved quality of life, and decreased symptoms of shortness of breath, chest pain, and heart palpitations, compared with VVI [20][21][22][24][25][26]. Therefore, rate-adaptive pacing is the first choice of pacing mode; fixed-rate VVI pacing should be abandoned in patients with permanent AF and atrioventricular block.…”

Qualidade de vida do portador de marcapasso cardíaco definitivo: antes e após implante

“…Exemplos são o Hacettepe Quality of Life Questionnaire, modificado e usado para comparar dois modos de programação de marcapasso por OTO et al (1991) e o Karolinska Questionnaire (LINDE-EDELSTAM et al, 1992), que tem perguntas gerais relativas a sintomas cardiovasculares.…”

Pacemaker Therapy: How do Patients Cope with the Icon of Modern Antibradycard Treatment?

“…During the VVIR-period the patients were able to exercise longer, they had less shortness of breath and more energy during daily activity. One group reported a simultaneous benefit in quality of life (Hacettepe Quality of Life Questionnaire) (38). However, using the Nottingham Health Profile (NHP) other authors saw only insignificant benefits concerning quality of life in the VVIR-group (39).…”