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Relationship Between Changes in Pulse Pressure and Frequency Domain Components of Heart Rate Variability During Short-Term Left Ventricular Pacing in Patients with Cardiac Resynchronization Therapy

Bożena Urbanek, Jan Ruta, Krzysztof Kudryński, Paweł Ptaszyński, Artur Klimczak, Jerzy Krzysztof Wranicz

Department of Electrocardiology, Medical University of Łódź, Łódź, Poland

Med Sci Monit 2016; 22:2043-2049

DOI: 10.12659/MSM.895489

Available online:

Published: 2016-06-15

BACKGROUND: The aim of the study was to explore the relationship between changes in pulse pressure (PP) and frequency domain heart rate variability (HRV) components caused by left ventricular pacing in patients with implanted cardiac resynchronization therapy (CRT).
MATERIAL AND METHODS: Forty patients (mean age 63±8.5 years) with chronic heart failure (CHF) and implanted CRT were enrolled in the study. The simultaneous 5-minute recording of beat-to-beat arterial systolic and diastolic blood pressure (SBP and DBP) by Finometer and standard electrocardiogram with CRT switched off (CRT/0) and left ventricular pacing (CRT/LV) was performed. PP (PP=SBP-DBP) and low- and high-frequency (LF and HF) HRV components were calculated, and the relationship between these parameters was analyzed.
RESULTS: Short-term CRT/LV in comparison to CRT/0 caused a statistically significant increase in the values of PP (P<0.05), LF (P<0.05), and HF (P<0.05). A statistically significant correlation between ΔPP and ΔHF (R=0.7384, P<0.05) was observed. The ΔHF of 6 ms2 during short-term CRT/LV predicted a PP increase of ≥10% with 84.21% sensitivity and 85.71% specificity.
CONCLUSIONS: During short-term left ventricular pacing in patients with CRT, a significant correlation between ΔPP and ΔHF was observed. ΔHF ≥6 ms2 may serve as a tool in the selection of a suitable site for placement of a left ventricular lead.

Keywords: Blood Pressure - physiology, Cardiac Resynchronization Therapy - methods, Heart Failure - therapy, Heart Rate - physiology, Heart Ventricles - physiopathology, Pacemaker, Artificial, Ventricular Function, Left - physiology