Chronotropic incompetence and abnormal heart rate recovery early after left ventricular assist device implantation.

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  • Additional Information
    • Source:
      Publisher: Futura Pub. Co. Country of Publication: United States NLM ID: 7803944 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8159 (Electronic) Linking ISSN: 01478389 NLM ISO Abbreviation: Pacing Clin Electrophysiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Mount Kisco, N. Y. : Futura Pub. Co., c1978-
    • Subject Terms:
      Heart-Assist Devices*; Heart Failure/*therapy ; Heart Rate/*physiology ; Heart Ventricles/*physiopathology; Adult ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Prosthesis Implantation ; Treatment Outcome
    • Abstract:
      Background: Chronotropic response to exercise and heart rate recovery immediately after exercise (HRR(1) ) are valid prognostic markers in patients with chronic heart failure (CHF). The aim of this study was to evaluate heart rate profile during and after exercise in CHF patients early after left ventricular assist device (LVAD) implantation.
      Methods: We enrolled seven stable consecutive CHF patients (five males, mean age: 45 ± 16 years) after 1 month of LVAD (HeartMate II; Thoratec Corp, Pleasanton, CA, USA) implantation, seven healthy subjects, and 14 patients with advanced HF (HF control group) who performed an incremental symptom-limited cardiopulmonary exercise testing (CPET). CHF patients performed CPET at 1 and 3 months after LVAD. HRR(1) was defined as the HR difference from peak to 1 minute after exercise and chronotropic response to exercise as the chronotropic reserve ([CR, %]=[peak HR-resting HR/220-age-resting HR]× 100).
      Results: LVAD patients 3 months after implantation had a significantly different HR profile during exercise compared to healthy controls, with significantly lower CR (57 ± 31 vs 90 ± 14, %, P < 0.001) and HRR(1) (14 ± 6 vs 28 ± 8, bpm, P < 0.01). HR profile during exercise did not significantly change 1 and 3 months after LVAD implantation. There was no statistical difference compared to HF control group and LVAD group regarding cardiopulmonary parameters.
      Conclusions: LVAD patients present an impaired CR and an abnormal HRR(1) after implantation, indicating significant cardiac autonomic abnormalities. These alterations seem to remain unaltered 3 months after LVAD implantation.
      (©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.)
    • Publication Date:
      Date Created: 20110929 Date Completed: 20120424 Latest Revision: 20111214
    • Publication Date:
      20240628
    • Accession Number:
      10.1111/j.1540-8159.2011.03215.x
    • Accession Number:
      21950763