Over the past decades, an increase in mortality from chronic heart failure (CHF) has been recorded, for the treatment of which the implantation of an electrocardiostimulator can be used. The medical support of the patient with a pacemaker was optimized depending on the functional class (FC) of CHF. An increase in both the frequency of prescription and the dose of (3-adrenergic receptor blockers with an increase in the FC of CHF in patients with CHF at a one-year follow-up period after implantation of pacemakers was shown. This not only improves myocardial contractility, but also reduces the risk of complications of pacing. Patients with implanted pacemakers require careful titration of medications taking into account the FC of CHF, especially with regard to its high FC, primarily for therapy with angiotensin-converting enzyme inhibitors, antiplatelet agents, and antiarrhythmic drugs. Keywords: chronic heart failure, pacemaker implantation, drug therapy.

The course of chronic heart failure (CHF) had been analyzed in patients with type 2 diabetes mellitus (DM) who had undergone pacemaker implantation, depending on body mass index (BMI). A retrospective analysis of echocardiographic data was carried out in 203 CHF patients who underwent pacemaker implantation, among whom 102 had concomitant type 2 diabetes (main group) and 101 participants did not have this metabolic pathology (control group). Pacemaker implantation was considered effective when the left ventricular end-diastolic volume (LV EDV) increased by 15 % after 12 months after operation. Patients who did not reach the target value of LV EDV were considered non-responders; analyzed the left ventricular ejection fraction (LVEF). In the main group, 22 patients (21,57 %) did not respond to implantation of the pacemaker, in the control group 12 people (11,9 %) did not respond to implantation of the pacemaker. Among the nonresponders, obese persons of the I, II and III degrees predominated. In the cohort of persons who responded to the establishment of the pacemaker, patients with a normal and increased BMI predominated; recorded a significant (p<0,001) increase in the mean values of LVEF in patients with normal BMI from (52,0±0,8) % to (61,4±0,8) %. Similar changes were noted in overweight patients: LVEF significantly (p<0,05) increased from (47,7±1,4) % to (55,1±1,3) %. Patients with CHF with concomitant type 2 diabetes, requiring pacemaker, have an inherent decrease in LVEF, which progressively decreases with increasing BMI. Low LVEF values are characteristic to patients with chronic heart failure, type 2 diabetes and morbid obesity. A good response to pacemaker implantation is associated with a normal, elevated BMI; failure to achieve the target value of LV EDV and insufficient growth of LVEF is more often recorded in the presence of concomitant obesity, especially of the II and III degrees. Keywords: heart failure, pacemaker, diabetes mellitus, left ventricular ejection fraction.

In recent decades, there has been a rise of chronic heart failure mortality. Among the huge range of modern methods of this pathology treatment, the cardioresynchronizing therapy stands out, it allows the improvement of the patient's heart function, reduces clinical signs of the disease, improves well−being, as well as diminishes morbidity and mortality. The use of this method in the patients with a comorbid pathology, i.e. in those with chronic heart failure and type 2 diabetes, deserves a special attention. In order to determine the clinical characteristics of the patients who required a pacemaker implantation, we examined 203 patients who had reasonable indications for this in accordance with the ACC / ANA and ESC current recommendations. Another important criterion for inclusion into the group of implantation was considered to be the presence of comorbid Diabetes mellitus type 2. The gender and age characteristics of the surveyed population were dominated by elderly male patients. The presence of concomitant cardiovascular pathology depending on the age of patients was analyzed, which showed mostly hypertension of stage 2−3, a constant atrial fibrillation. In structure of comorbid pathology the somatic diseases, including type 2 Diabetes mellitus prevailed. Electrostimulators were implanted into the examined cohort of patients, among which 132 devices worked in DDD mode, 71 of the installed stimulators had the DDDR mode. The research results concluded that the implantation of a pacemaker became a necessary procedure for elderly patients, mostly men, with a high prevalence of cardiovascular (coronary heart disease, hypertension, persistent atrial fibrillation) and somatic pathology in the form of type 2 Diabetes mellitus. Key words: chronic heart failure, type 2 diabetes mellitus, pacemaker implantation, clinical features, gender and age characteristics.

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