The HeartQoL: Part I. Development of a new core health-related quality of life questionnaire for patients with ischemic heart disease

Objective Outcome data on exercise capacity following atrio-ventricular (AV) optimization of dual-chamber pacing are sparse. Pacemaker settings are often left at manufacturers' nominal values upon implantation. We studied the short-term effect of AV optimization on exercise capacity in patients with a dual-chamber pacemaker. Methods and resultsTwenty-eight patients (mean age 73 ± 14 y) with a dual-chamber pacemaker, were randomized towards either nominal AV settings (group 1) or echo-guided AV optimization using the iterative mitral inflow VTI (velocity time integral) method (group 2) at baseline. At 4 weeks, patients were crossed-over to AV optimization in group 1 and returned to nominal AV settings in group 2 for another period of 4 weeks.Oxygen uptake efficiency slope improved significantly after AV optimization (by 126.7 mL/logL ± 190.7 mL/logL; P = 0.003).Conclusions AV optimization in dual-chamber pacing significantly improved functional capacity after 4 weeks. These data provide the background for further validation studies. Keywords AV optimization -interatrial conduction delay -interatrial mechanical delay -dual-chamber pacemaker.contraction of the left atrium can compromise left ventricular filling, leading to an early increase in atrial filling pressures and a limitation in functional exercise capacity 2 . Oxygen uptake efficiency slope (OUES) is a validated marker of exercise capacity in healthy subjects and in patients with heart failure 3 .Resolution of left AV asynchrony in DDD pacing can be obtained by AV delay optimization and has been shown to improve acute haemodynamics in patients with an important IACD 4,5 . Several validated methods for AV optimization exist 6 . However, data on the effects of this intervention on short-and long-term clinical end points as exercise capacity, morbidity and mortality, are sparse.The aim of this pilot study was to investigate the short-term effect of AV optimization on functional [ Original article ]

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“…Therefore, comparison of HRQoL among subgroups has become an important focus. Two HRQoL questionnaires have recently been shown to allow for comparison among different diagnostic groups -the HeartQol and the MacNew [130][131][132]. The HeartQol, in particular, has demonstrated validity across 22 countries and several languages and has been shown to predict 5-year mortality and cardiac readmissions in patients with ischaemic heart disease [133].…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

Psychological Aspects of Cardiac Care and Rehabilitation: Time to Wake Up to Sleep?

2015

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Psychological aspects of cardiac care & rehabilitation: Time to wake up to sleep? Abstract:Psychological and psychosocial factors have long been linked to cardiovascular disease. These psychosocial factors, including low socioeconomic status, social support/isolation, stress and distress, personality and sleep disturbance increase risk of cardiovascular events and negatively impact on quality of life. These factors may have direct effects on cardiovascular disease via immune or neuroendocrine pathways, or more indirect effects, by for example limiting adherence to recommended therapies and cardiac rehabilitation. Most psychosocial risk factors can be assessed relatively easily using standardised tools. Sleep disturbance, in particular, is gaining evidence for its importance, and may be crucial to address. While the management of certain psychosocial risk factors is an ethical requirement for care and improves quality of life, unfortunately there is little evidence that such strategies impact on 'hard' endpoints such as recurrent myocardial infarction. A comprehensive biopsychosocial approach to management of these psychosocial factors is required to maximise the benefits patients derive from cardiac care.

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The HeartQoL: Part I. Development of a new core health-related quality of life questionnaire for patients with ischemic heart disease

Cited by 124 publications

References 22 publications

Revisiting the dimensionality of the Hospital Anxiety and Depression Scale in an international sample of patients with ischaemic heart disease

Revisiting the dimensionality of the Hospital Anxiety and Depression Scale in an international sample of patients with ischaemic heart disease

Clinical benefit of atrio-ventricular delay optimization in patients with a dual-chamber pacemaker: a pilot study. The CBRAVO trial (NCT01998256)

Psychological Aspects of Cardiac Care and Rehabilitation: Time to Wake Up to Sleep?

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