Non-invasive haemodynamics to guide pacemaker programming
Research type
Research Study
Full title
Optimising Heart Rate for Contractility in patients with pacemaker devices using peripheral haemodynamics: closing in on personalised programming for all.
IRAS ID
311354
Contact name
Klaus Witte
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
4 years, 11 months, 31 days
Research summary
Even if they are taking all the right tablets, people with heart muscle weakness (known as heart failure) very often have persistent symptoms of breathlessness and fatigue when they do activity.
The persistence of these symptoms is thought, at least in part, to be due to limited increases in heart rate during activity. However, simply increasing the heart rate using a pacemaker does not improve exercise capacity in people with heart failure. This is because in people with heart failure, a faster heart beat is often associated with less power.
We have shown that we can measure the best heart rate range for each person’s heart using an ultrasound scan of the heart by setting the pacemaker to pace the heart at 5 or 6 different heart rates and do a normal ultrasound heart scan and a blood pressure at each heart rate. If we use this information to program the pacemaker to keep their heart rate in the optimal heart rate range, people can do more exercise even though their heart rate is kept lower than would be usual with standard programming.
The measurement of the optimal heart rate range takes about 45 minutes making it difficult to repeat the test in a routine pacemaker clinic. We have found an approved device already in use in the NHS designed to measure heart power using blood pressure cuffs around the fingers which could quickly identify the optimal heart rate range within a few minutes.
We will ask 200 people with heart failure and a pacemaker in three hospitals in Yorkshire to have an assessment of their heart power range using both the ultrasound scan and the finger monitor compare how the two results relate to each other and therefore whether the finger pressure technique could be part of routine care.
REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
22/SW/0030
Date of REC Opinion
4 Mar 2022
REC opinion
Favourable Opinion