Dual chamber pacing with optimal AV delay in congestive heart failure - A randomized study

Aim A prospective randomized trial was set up to evaluate contractile param eters and quality of life in patients with congestive heart failure. Methods and Results We describe the results from 38 patients in sinus rhyth m and with chronic heart failure due to congestive cardiomyopathy, prospect ively randomized to optimal medical therapy (Group 1, 19 patients) or optim al medical therapy plus dual chamber pacemaker programmed to optimal AV del ay (Group 2, 19 patients). At a 6 month follow-up. 7/19 patients in Group 1 had died compared with 5/1 9 patients in Group 2. During follow-up, there were few significant changes in evaluated parameters except for mitral regurgitation time, which was pr olonged in Group 1 and shortened in Group 2. The systolic left ventricular diameter shortened significantly only in Group 2. An energy and activity qu estionnaire showed that the effect of DDD pacing in the latter patient popu lation was beneficial. Conclusions From these results we may conclude that at the 6 month follow-u p DDD pacing with echo-optimized AV interval programming can improve qualit y of life without affecting survival.