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Cardiac Resynchronization Therapy Improves Heart Rate Profile and Heart Rate Variability of Patients With Moderate to Severe Heart Failure

Cecilia Fantoni, MD^_*,, Santi Raffa, MD^_*, Francois Regoli, MD^_*, Francesco Giraldi, MD, Maria Teresa La Rovere, MD, John Prentice, PhD^||, Francesca Pastori, MD^_*, Simona Fratini, MD, PhD^_*, Jorge A. Salerno-Uriarte, MD, Helmut U. Klein, MD^_* and Angelo Auricchio, MD, PhD^_*,_*

^_* Division of Cardiology, University Hospital, Magdeburg, Germany
Department of Cardiovascular Sciences, University of Insubria, Varese, Italy
Centro Cardiologico Monzino, Milan, Italy
Department of Cardiology, Centro Medico di Montescano, S. Maugeri Foundation, IRCSS, Pavia, Italy
^|| Wild Rose Biophysics, Boulder, Colorado

View larger version (21K): [in a new window]   Figure 1 Dynamic changes of standard deviation of the averages of intrinsic intervals in the 288 five-min segments of a day (SDANN), mean heart rate (HR), and minimum HR based on fitted data (filled circles). For baseline, 90%, 95%, and 99% of the value to plateau, the mean value based on the raw data (open circles) is reported with the standard error (Y axis).

View larger version (21K): [in a new window]   Figure 2 The two-year cumulative event-free survival rate in patients with no changes in standard deviation of the averages of intrinsic intervals in the 288 five-minute segments of a day (SDANN) four weeks after implantation (first tertile, change 0%), in patients with some SDANN changes (second tertile, change from 0 to 17%), and in those with large SDANN changes (third tertile, change 17%). CRT = cardiac resynchronization therapy; CV hospitalization = hospitalizations for cardiovascular reasons.

View larger version (26K): [in a new window]   Figure 3 Change of left ventricular ejection fraction, left ventricular end-diastolic diameter, and oxygen consumption at peak exercise from baseline to one-year follow-up (FU) in responders (dotted lines) and non-responders (continuous lines) to cardiac resynchronization therapy (CRT), according to changes of standard deviation of the averages of intrinsic intervals in the 288 five-minute segments of a day (SDANN) four weeks after CRT implantation. The vertical bars represent the standard error. The p values refer to comparison between baseline and follow-up among each group. (Bottom right) distribution of locations of the left ventricular lead tip in a left anterior oblique (LAO) 40° view among responders and non-responders. The p value refers to comparison between responders and non-responders.