TY - JOUR
T1 - Pacemaker-Mediated Programmable Hypertension Control Therapy
AU - Neuzil, Petr
AU - Merkely, Béla
AU - Erglis, Andrejs
AU - Marinskis, Germanas
AU - de Groot, Joris R.
AU - Schmidinger, Herwig
AU - Rodriguez Venegas, Manuel
AU - Voskuil, Michiel
AU - Sturmberger, Thomas
AU - Petru, Jan
AU - Jongejan, Niels
AU - Aichinger, Josef
AU - Kamzola, Ginta
AU - Aidietis, Audrius
AU - Gellér, Laszlo
AU - Mraz, Tomas
AU - Osztheimer, Istvan
AU - Mika, Yuval
AU - Evans, Steven
AU - Burkhoff, Daniel
AU - Kuck, Karl-Heinz
AU - AUTHOR GROUP
AU - Simon, Jaroslav
AU - Dujka, Libor
AU - Machalek, Libor
AU - Király, Ákos
AU - Molnár, Levente
AU - Kovács, Attila
AU - Szabó, Marianna
AU - Kupics, Kaspars
AU - Ansaberga, Ieva
AU - Ansabergs, Janis
AU - Nesterovics, Nikolajs
AU - Barysiene, Jurate
AU - van Cruijsen, Marc
AU - Schellevis, Mindel M.
AU - Pezawas, Thomas
AU - Flores, Emilio
AU - Fullerton, Demian
AU - Beeftink, Martine M. A.
AU - Meine, Matthias
AU - Ascheim, Deborah D.
AU - Dizon, Jose
AU - Hanon, Samuel
AU - Hastings, Harold
PY - 2017
Y1 - 2017
N2 - Background-Many patients requiring a pacemaker have persistent hypertension with systolic blood pressures above recommended levels. We evaluated a pacemaker-based Programmable Hypertension Control (PHC) therapy that uses a sequence of variably timed shorter and longer atrioventricular intervals. Methods and Results-Patients indicated for dual-chamber pacing with office systolic blood pressure (oSBP) > 150 mm Hg despite stable medical therapy were implanted with a Moderato (TM) pulse generator that delivers PHC therapy. Patients were followed for 1 month (Run-In period) with conventional pacing; those with persistent oSBP > 140 mm Hg were included in the study and had PHC therapy activated. The co-primary efficacy end points were changes in 24-hour ambulatory systolic blood pressure and oSBP between baseline and 3 months. Safety was assessed by tracking adverse events. Thirty-five patients met the initial inclusion criteria and underwent Moderato implantation. At 1 month, oSBP was <140 mm Hg in 7 patients who were excluded. PHC was activated in the remaining 27 patients with baseline office blood pressure 166 +/- 11/80 +/- 10 mm Hg despite an average of 3.2 antihypertensive medications. During the Run-In period, oSBP and 24-hour ambulatory systolic blood pressure decreased by 8 +/- 13 and 5 +/- 12 mm Hg (P <0.002), respectively. Compared with pre-PHC activation measurements, oSBP decreased by another 16 +/- 15 mm Hg and 24-hour ambulatory systolic blood pressure decreased by an additional 10 +/- 13 mm Hg (both P <0.01) at 3 months. No device-related serious adverse effects were noted. Conclusions-In pacemaker patients with persistent hypertension despite medical therapy, oSBP and 24-hour ambulatory systolic blood pressure are decreased by PHC therapy. Initial indications are that this therapy is a safe and promising therapy for such patients
AB - Background-Many patients requiring a pacemaker have persistent hypertension with systolic blood pressures above recommended levels. We evaluated a pacemaker-based Programmable Hypertension Control (PHC) therapy that uses a sequence of variably timed shorter and longer atrioventricular intervals. Methods and Results-Patients indicated for dual-chamber pacing with office systolic blood pressure (oSBP) > 150 mm Hg despite stable medical therapy were implanted with a Moderato (TM) pulse generator that delivers PHC therapy. Patients were followed for 1 month (Run-In period) with conventional pacing; those with persistent oSBP > 140 mm Hg were included in the study and had PHC therapy activated. The co-primary efficacy end points were changes in 24-hour ambulatory systolic blood pressure and oSBP between baseline and 3 months. Safety was assessed by tracking adverse events. Thirty-five patients met the initial inclusion criteria and underwent Moderato implantation. At 1 month, oSBP was <140 mm Hg in 7 patients who were excluded. PHC was activated in the remaining 27 patients with baseline office blood pressure 166 +/- 11/80 +/- 10 mm Hg despite an average of 3.2 antihypertensive medications. During the Run-In period, oSBP and 24-hour ambulatory systolic blood pressure decreased by 8 +/- 13 and 5 +/- 12 mm Hg (P <0.002), respectively. Compared with pre-PHC activation measurements, oSBP decreased by another 16 +/- 15 mm Hg and 24-hour ambulatory systolic blood pressure decreased by an additional 10 +/- 13 mm Hg (both P <0.01) at 3 months. No device-related serious adverse effects were noted. Conclusions-In pacemaker patients with persistent hypertension despite medical therapy, oSBP and 24-hour ambulatory systolic blood pressure are decreased by PHC therapy. Initial indications are that this therapy is a safe and promising therapy for such patients
U2 - https://doi.org/10.1161/JAHA.117.006974
DO - https://doi.org/10.1161/JAHA.117.006974
M3 - Article
C2 - 29275370
SN - 2047-9980
VL - 6
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 12
M1 - e006974
ER -