P8.11 EFFECT OF CARDIAC RESYNCHRONISATION THERAPY ON THE AUTONOMIC NERVOUS SYSTEM FUNCTION

• Main Authors: Anna Przybyla*, Danuta Czarnecka
• Format: Article
• Language: English
• Published: Atlantis Press 2015-11-01
• Series: Artery Research
• Online Access: https://www.atlantis-press.com/article/125930692/view

Development of cardiac resynchronisation therapy (CRT) in recent years became a breakthrough in treatment of severe heart failure. The aim of this study was evaluation of CRT effect on the autonomous nervous system function. Methods: The study covered a group of 55 patients (45 men, 10 women; mean age 67.04±9.13 years) with chronic heart failure stable for at least last 3 months, in the NYHA functional class III or IV despite optimal pharmacotherapy, with a reduced left ventricular ejection fraction ≤ 35%, wide QRS complexes ≥ 120 ms, and sinus rhythm present during the examination. Before the resynchronisation system was implanted and after three months of observation arterial baroreflex sensitivity (BRS) was evaluated with the sequence technique, and with the α coefficient and the transfer function. Results: Three months after implantation of the CRT device, a statistically significant increase in the arterial baroreflex sensitivity was observed for all methods used in the study, both when lying and breathing spontaneously (BRSseq: 5,96±2,07 ms/mmHg vs 7,64±4,73 ms/mmHg, p<0,001; αLF: 6,00±4,44 ms/mmHg vs 7,68±5,09 ms/mmHg, p=0,029; αHF: 6,53±3,19 ms/mmHg vs 10,15±6,84 ms/mmHg, p<0,001; TFLF: 3,18±3,05 ms/mmHg vs 4,18±3,17 ms/mmHg, p=0,01; TFHF: 3,54±2,02 ms/mmHg vs 5,72±4,24 ms/mmHg, p<0,001), as well as when lying with breathing controlled. Furthermore, after three months from the CRT implementation, all monitored BRS indicators were significantly reduced in response to orthostatic stimulus. Such modulatory ability was not observed before implantation of the CRT device. Conclusions: The study confirmed the beneficial effect of the CRT on the autonomous nervous system function.