People with mild heart failure benefit from biventricular pacing

6th October 2015

Biventricular pacing has long term benefits for people with mild heart failure, says a new study.

Biventricular pacing, sometimes called cardiac resynchronisation therapy, helps the heart pump in a more synchronised way and can help reduce symptoms.

In some people with moderate or severe heart failure, biventricular pacemakers make heart function improve dramatically but in others it does not. Studies at centres around the world are assessing which groups of people benefit most. Many people with mild heart failure do not qualify for a biventricular pacemaker on the NHS.

Researchers did a five year follow up study of  data from a study of biventricular pacemaker looking at hospital admissions and survival.

They performed two comparisons: people with  biventricular pacemakers that were turned on versus those with the device turned off, and people with devices with a built-in defibrillator versus those without a defibrillator.

Having the device turned on was predicted to increase survival by 22.8%. Having a defibrillator further increased survival. 

People with New York Heart Association (NYHA) functional class II (mild symptoms and slight limitation during ordinary activity) had a 30.6% higher risk of hospital admission for heart failure than those in class I (no symptoms and no limitation in ordinary physical activity,) and a  three times lower rate compared with class III (marked limitation in activity due to symptoms, even during walking 20 to 100 metres).
The researchers concluded there were important long-term benefits of biventricular pacemaking in mild heart failure. These findings were particularly striking in the light of data suggesting underuse of biventricular pacemakers in the real world, said the team.

The research was published in the Journal of the American College of Cardiology.

Long-Term Extrapolation of Clinical Benefits Among Patients With Mild Heart Failure Receiving Cardiac Resynchronization Therapy: Analysis of the 5-Year Follow-Up From the REVERSE Study.