Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial

Whinnett Zachary I.; Shun-Shin Matthew J.; Tanner MarkFoley PaulChandrasekaran BadriMoore PhilipAdhya ShaumikQureshi NormanMuthumala AmalLane RebeccaRinaldi AldoAgarwal SharadLeyva FranciscoBehar JonathanBassi SukhNg AndreScott PaulPrasad RachanaSwinburn JonTomson JosephSethi AmarjitShah JayminLim Phang BoonKyriacou AndreasThomas DewiChuen JennyKamdar RaviKanagaratnam PrapaMariveles MyrilBurden LeahMarch KatherineHoward James P.Arnold AhranVijayaraman PugazhendhiStegemann BertholdJohnson NicholasFalaschetti EmanuelaFrancis Darrel P.Cleland John G. F.Keene Daniel

首页> 外文期刊>European journal of heart failure: journal of the Working Group on Heart Failure of the European Society of Cardiology >Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial

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Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial

机译：Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial

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Aims Excessive prolongation of PR interval impairs coupling of atrio-ventricular (AV) contraction, which reduces left ventricular pre-load and stroke volume, and worsens symptoms. His bundle pacing allows AV delay shortening while maintaining normal ventricular activation. HOPE-HF evaluated whether AV optimized His pacing is preferable to no-pacing, in a double-blind cross-over fashion, in patients with heart failure, left ventricular ejection fraction (LVEF)= 200 ms and either QRS <= 140 ms or right bundle branch block. Methods and results Patients had atrial and His bundle leads implanted (and an implantable cardioverter-defibrillator lead if clinically indicated) and were randomized to 6 months of pacing and 6 months of no-pacing utilizing a cross-over design. The primary outcome was peak oxygen uptake during symptom-limited exercise. Quality of life, LVEF and patients' holistic symptomatic preference between arms were secondary outcomes. Overall, 167 patients were randomized: 90 men, 69 +/- 10 years, QRS duration 124 +/- 26 ms, PR interval 249 +/- 59 ms, LVEF 33 +/- 9. Neither peak oxygen uptake (+0.25 ml/kg/min, 95 confidence interval CI -0.23 to +0.73, p = 0.3) nor LVEF (+0.5, 95 CI -0.7 to 1.6, p = 0.4) changed with pacing but Minnesota Living with Heart Failure quality of life improved significantly (-3.7, 95 CI -7.1 to -0.3, p = 0.03). Seventy-six percent of patients preferred His bundle pacing-on and 24 pacing-off (p < 0.0001). Conclusion His bundle pacing did not increase peak oxygen uptake but, under double-blind conditions, significantly improved quality of life and was symptomatically preferred by the clear majority of patients. Ventricular pacing delivered via the His bundle did not adversely impact ventricular function during the 6 months. GRAPHICS .

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《European journal of heart failure: journal of the Working Group on Heart Failure of the European Society of Cardiology》 |2023年第2期|274-283|共10页
作者
Whinnett Zachary I.; Shun-Shin Matthew J.; Tanner MarkFoley PaulChandrasekaran BadriMoore PhilipAdhya ShaumikQureshi NormanMuthumala AmalLane RebeccaRinaldi AldoAgarwal SharadLeyva FranciscoBehar JonathanBassi SukhNg AndreScott PaulPrasad RachanaSwinburn JonTomson JosephSethi AmarjitShah JayminLim Phang BoonKyriacou AndreasThomas DewiChuen JennyKamdar RaviKanagaratnam PrapaMariveles MyrilBurden LeahMarch KatherineHoward James P.Arnold AhranVijayaraman PugazhendhiStegemann BertholdJohnson NicholasFalaschetti EmanuelaFrancis Darrel P.Cleland John G. F.Keene Daniel;
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Kings Coll NHS Hosp;

Kettering & Dist Gen Hosp;

Royal Berkshire NHS Fdn TrustRoyal Free London Fdn NHS TrustLondon North West Univ Healthcare NHS TrustImperial College London,Natl Heart & Lung InstSheffield Teaching Hosp NHS Fdn TrustMorriston Hosp Reg Cardiac CtrNottingham Univ Hosp NHS TrustCroydon NHS Univ HospImperial Coll Healthcare NHS TrustGeisinger Commonwealth Sch Med,Geisinger Heart InstImperial Coll Trials Unit,Imperial Coll LondonSch Hlth & Wellbeing,Univ GlasgowWest Sussex Hosp NHS TrustGreat Western Hosp NHS Fdn TrustWest Hertfordshire Hosp NHS TrustMedway NHS Fdn TrustWycombe Gen HospBarts Hlth NHS TrustHeart & Lung Inst,Royal Brompton & Harefield NHS TrustGuys & St Thomass NHS Fdn TrustRoyal Papworth Hosp NHS Fdn TrustUniv Hosp BirminghamSherwood Forest Hosp NHS Fdn TrustDept Cardiovasc Sci,Univ Leicester;

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正文语种英语
中图分类心脏、血管（循环系）疾病;
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His bundle pacing; Atrio-ventricular optimization; Randomized controlled trial; PR prolongation; Heart failure; CARDIAC-RESYNCHRONIZATION THERAPY; LEFT-VENTRICULAR DYSFUNCTION; MULTISITE STIMULATION; DISEASE PROGRESSION; DUAL-CHAMBER; DEFIBRILLATOR; CARDIOMYOPATHY; PREVENTION; BENEFIT; DELAY;

Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial

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