Physical Impairments in Heart Failure Patients With Pacemakers
Condition: Heart Failure Patients
MeSH terms: Heart Failure
Study type: Observational

Summary: 
      Despite major breakthroughs that have recently been made in pacemakers implanted in heart
      failure (HF) patients, it is clear that functional impairments and symptoms often remain.
      However, only limited studies have investigated exercise capacity, muscle strength, pulmonary
      function, dyspnea, and fatigue in pacemaker implanted HF patients. Therefore, investigators
      aimed to compare the aforementioned outcomes in patients and healthy controls.
    

Detailed description: 
      Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump
      enough blood through to meet the body's needs for blood and oxygen. Safeguarding HF patients
      at increased risk of sudden cardiac death due to ventricular arrhythmias and HF as a result
      of left ventricular systolic dysfunction and cardiac abnormal synchronization has continued
      to improve. Implantable cardioverter defibrillators (ICDs), which restore normal heart rhythm
      using pacing, cardioversion or defibrillation, and cardiac resynchronization therapy (CRT),
      which resynchronizes the contraction of the heart using biventricular pacing, are nowadays
      widely used to treat the aforementioned conditions.

      New developments in medical treatments have focused on the primary affected organs, targeting
      reduced left ventricular ejection fraction in chronic HF. Although major breakthroughs in the
      treatments have occurred in recent years, especially implantable medical devices, it is clear
      that when drugs are optimally prescribed, even the latest technology used in pacemakers
      reported problems, especially functional impairments and symptoms often remain. In recent
      decades, it has become obvious that disease severity should not be estimated from cardiac
      function impairment alone. However, what has not hitherto been clearly investigated is the
      fact that even functional and maximal exercise capacity, respiratory and peripheral muscle
      strength and pulmonary function are impaired, and dyspnea in the activities of daily living
      and fatigue perception increased in HF patients with pacemakers.

      Hence, investiators designed a prospective, cross-sectional study to compare the
      aforementioned outcomes in HF patients with pacemakers and healthy controls. Investigators
      hypothesized that functional and maximal exercise capacity, respiratory and peripheral muscle
      strength, and pulmonary function are impaired, and dyspnea in the activities of daily living,
      and fatigue perception increased in HF patients with pacemakers.

      A cross-sectional study. 50 HF patients with pacemakers and 40 controls were compared.
      Functional (6-Minute Walking test (6-MWT)) and maximal exercise capacity (Incremental Shuttle
      Walking test (ISWT)), respiratory (MIP, MEP; Mouth pressure device) and peripheral muscle
      strength (Dynamometer), pulmonary function (Spirometry) dyspnea (Modified Medical Research
      Council Dyspnea scale) (MMRC)), and fatigue (Fatigue Severity scale (FSS)) were evaluated.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Prior to evaluation, all patients' clinical evaluation and echocardiographic measurements
        and pacemaker routine controls were conducted by a cardiologist. All patients and controls
        were tested by a physical therapist. Demographic characteristics were recorded. Functional
        and maximal exercise capacity, respiratory and peripheral muscle strength, pulmonary
        function, dyspnea and fatigue perception were evaluated and compared with age- and
        gender-matched healthy controls (without any chronic diseases) who volunteered to
        participate to the study.
      
Keywords: heart failure; pacemaker; exercise test; muscle strength; dyspnea; fatigue