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ORLANDO, Fla., Mar 20, 2001 (United Press International via COMTEX) -- About 1 million patients with severe heart failure -- a condition that markedly limits normal activity -- could benefit from a pacemaker procedure that synchronizes the heart's rhythm.
After implantation of the device, 69 percent of patients improved to the point where they were able to resume many activities of daily living, said Dr. William Abraham, chief of the division of cardiovascular medicine at the University of Kentucky Hospital in Lexington. Prior to implantation these patients were unable to walk across a room without suffering shortness of breath.
The findings were reported Tuesday at the annual meeting of the American College of Cardiology in Orlando, Fla.
"These study results should bring hope to thousands of patients whose quality of life has been severely affected by heart failure," Abraham said. "Cardiac re-synchronization therapy may allow many patients who are not helped by drugs alone to resume many of their normal activities."
A key aspect of the study was that doctors were able to compare the results of the pacing procedure against a similar group of patients.
Pacemakers were implanted in all the patients, but in half of the 266 patients, the devices were not activated. The 69 percent of patients with active implants who improved were able to do so by one class on the four-class scale developed by the New York Heart Association. Among the patients with the inactive devices, only 34 percent were able to improve their status by one class.
"Class III and Class IV heart failure patients are severely limited in their activities," said Dr. Sidney Smith, chief science officer of the American Heart Association. "An improvement in one class is significant."
After six months, the researchers asked the patients who did not have the pacemakers activated if they wanted the devices turned on. "Universally, they asked to activate the devices," Abraham said.
Abraham said the procedure involves implanting a pacemaker and then running pacing wires to the upper chamber of the heart -- the atrium -- and then implanting wires in both lower chambers -- the ventricles -- to synchronize motion of the heart, and improve heart function.
He said the study found that patients with the re-synchronized pacing reported significant improvements in quality of life and were able to perform longer on standard exercise testing.
Abraham said that about one-fourth of heart failure patients have heart muscles that are not beating synchronously, meaning that about 750,000 to 1.25 million people in the United States might be candidates for the procedure.
The device is manufactured by Medtronic Inc. of Minneapolis, Minn., which sponsored the study. The company is seeking U.S. approval to use the device in heart failure patients.
"This is a new innovative therapy and a very encouraging report," said Smith, also professor of medicine at the University of North Carolina, Chapel Hill.
The patients being fitted with the pacemakers in the study were all maintained on medical therapy as well, but their conditions continued to deteriorate. Heart failure often occurs as a result of damage to the muscle following a heart attack, although other conditions can also cause the progressive disorder.
By ED SUSMAN, UPI Science News
Copyright 2001 by United Press International.
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