Literature DB >> 9875118

"Value" of improved treadmill exercise capacity: lessons from a study of rate responsive pacing.

A D Staniforth1, R Andrews, M Harrison, A Perry, A J Cowley.   

Abstract

OBJECTIVES: To compare the value of a series of cardiovascular measurements in patients with symptomatic disease receiving an effective treatment (rate responsive pacing). PATIENTS: 12 pacemaker dependent patients with VVIR units.
INTERVENTIONS: Single blind crossover between VVI and VVIR. OUTCOME MEASURES: Exercise capacity was assessed by treadmill tests (modified Bruce protocol and a fixed workload protocol) with respiratory gas analysis. Self paced corridor walk tests were also undertaken. Quality of life (QOL) was assessed by questionnaire. Daily activity was measured in the patients' homes using shoe and belt pedometers.
RESULTS: Treadmill tests and QOL questionnaires correctly identified the clinical benefit associated with VVIR. The modified Bruce protocol was superior to the fixed workload protocol as it was better tailored to the fairly well preserved exercise capacity of the patients. Symptom scores, but not walking times, were improved with VVIR during corridor walk tests. VVIR did not improve daily activity measured using either the belt or shoe pedometers.
CONCLUSIONS: VVIR pacing improved some but not all measures of exercise capacity. This finding illustrates the difficulty of selecting an instrument to measure symptomatic improvement in clinical research; and raises the question, what is the best way of measuring exercise capacity?

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Year:  1998        PMID: 9875118      PMCID: PMC1728825          DOI: 10.1136/hrt.80.4.383

Source DB:  PubMed          Journal:  Heart        ISSN: 1355-6037            Impact factor:   5.994


  18 in total

1.  QT sensing rate responsive pacing compared to fixed rate ventricular inhibited pacing: a controlled clinical study.

Authors:  A Hedman; R Nordlander
Journal:  Pacing Clin Electrophysiol       Date:  1989-02       Impact factor: 1.976

2.  Single-chamber cardiac pacing with activity-initiated chronotropic response: evaluation by cardiopulmonary exercise testing.

Authors:  D G Benditt; M Mianulli; J Fetter; D W Benson; A Dunnigan; E Molina; C C Gornick; A Almquist
Journal:  Circulation       Date:  1987-01       Impact factor: 29.690

3.  Perceived exertion: a note on "history" and methods.

Authors:  G A Borg
Journal:  Med Sci Sports       Date:  1973

4.  Validation of a simple mechanical accelerometer (pedometer) for the estimation of walking activity.

Authors:  E J Bassey; H M Dallosso; P H Fentem; J M Irving; J M Patrick
Journal:  Eur J Appl Physiol Occup Physiol       Date:  1987

5.  Randomised crossover trial of rate responsive Activitrax and conventional fixed rate ventricular pacing.

Authors:  D P Lipkin; N Buller; M Frenneaux; L Ludgate; T Lowe; S C Webb; D M Krikler
Journal:  Br Heart J       Date:  1987-12

6.  A non-invasive method for measuring cardiac output: the effect of Christmas lunch.

Authors:  A J Cowley; K Stainer; D T Murphy; J Murphy; J R Hampton
Journal:  Lancet       Date:  1986 Dec 20-27       Impact factor: 79.321

7.  Relation of daily activity levels in patients with chronic heart failure to long-term prognosis.

Authors:  J T Walsh; A Charlesworth; R Andrews; M Hawkins; A J Cowley
Journal:  Am J Cardiol       Date:  1997-05-15       Impact factor: 2.778

8.  Is accurate rate response programming necessary?

Authors:  N Sulke; A Dritsas; J Chambers; E Sowton
Journal:  Pacing Clin Electrophysiol       Date:  1990-08       Impact factor: 1.976

9.  Quality of life in patients with rate responsive pacemakers: a randomized, cross-over study.

Authors:  M A Oto; H Müderrisoglu; M B Ozin; M E Korkmaz; A Karamehmetoglu; A Oram; E Oram; S Ugurlu
Journal:  Pacing Clin Electrophysiol       Date:  1991-05       Impact factor: 1.976

10.  Increase in cardiac output with rate-responsive pacemaker.

Authors:  F Beyersdorf; J Kreuzer; T A Happ; M Zegelman; P Satter
Journal:  Ann Thorac Surg       Date:  1986-08       Impact factor: 4.330

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