Clinical Outcomes With Personalized Accelerated Physiologic Pacing in Heart Failure With Preserved Ejection Fraction

Does personalized, moderately accelerated physiologic pacing reduce adverse clinical events in patients with stage B and C heart failure with preserved ejection fraction (HFpEF) compared to conventional pacing at 60 beats per minute?In this extended observational follow-up of 100 patients from the myPACE randomized clinical trial, intention-to-treat analysis showed nonsignificant trends toward fewer clinical events. However, prespecified per-protocol analysis of patients who continued their assigned treatment showed significantly slower accrual of adverse events and longer time to first event with personalized pacing.The findings indicate that personalized accelerated pacing was not associated with an increase in adverse clinical events over 4-year follow-up and may reduce adverse clinical events in patients with HFpEF.

Corresponding Authors: Margaret Infeld MD, MS, Cardiovascular Center, Tufts Medical Center, 800 Washington St, 6 South, Office 6121, Boston, MA 02111 (margaret.infeld@tuftsmedicine.org); Markus Meyer, MD, PhD, Lillehei Heart Institute, Department of Medicine, University of Minnesota College of Medicine, 2231 6th St SE, 4-165 CCRB, Minneapolis, MN 55455 (markusmeyermd@gmail.com).

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