Medstar Health Research Institute
This is a prospective, randomized crossover study. The objective of the study is to determine if a pacing rate of 80 beats per minute (bpm) improves exercise tolerance during the 6-minute walk test. The investigators will randomly assign half of the participants to a starting rate of 60 bpm and then switch them to a rate of 80 bpm for 3 months, and vice versa.
Cardiac resynchronization therapy (CRT) after atrioventricular node (AVN) ablation for permanent atrial fibrillation (AF) has led to better outcomes in heart failure (HF) patients with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF) compared to pharmacotherapy. Emerging evidence has demonstrated patients with HFpEF may benefit from a higher heart rate compared to standard heart-lowering therapies. The optimal pacing rate for CRT after AVN ablation in persistent AF and HFpEF remains unknown. This is a prospective, randomized crossover study. The objective of the…
Inclusion Criteria: 1. Age 18 years or older 2. History of persistent or permanent atrial fibrillation 3. Implantation of CRT or conduction system pacing in prior 3 months to 5 years of study start 4. History of intrinsic AVN block or have undergone AVN ablation in prior 3 months to 5 years of study start 5. LVEF ≥ 50% 6. N-terminal pro-B-type natriuretic peptide (NT-proBNP) \>400 pg/mL in the last 24 months 7. Clinical HF diagnosis or NYHA class II or higher 8. Able to provide informed consent Exclusion Criteria: 1. LVEF \<50% 2. Wide QRS (greater than 150ms) 3. Isolated RV pacing 4. Sever…
Pacing rate of 80 bpm
Pacing rate of 60 bpm