Dual chamber pacing in patients with severe heart failure on [beta] blocker and amiodarone treatment: preliminary results of a randomised study. (Scientific Letter).

Standard dual chamber pacing was first used as adjunctive treatment for severe congestive heart failure in the early 1990s. (1) It was proposed that a short atrioventricular delay reduced presystolic mitral regurgitation. (2,3) It also may correct chronotropic incompetence and protect against fatal brady-arrhythmias.

We performed a randomised study to test whether DDDR pacing with optimised atrioventricular (AV) delay and reversal of drug induced bradycardia by rate responsive pacing was beneficial in heart failure patients who were receiving combined treatment with amiodarone and [beta] blockers as empirical prophylaxis against sudden tachyarrhythmic death. (4)

In 82 patients with severe heart failure submitted for heart transplantation and without a conventional pacemaker indication between 1996 and 1998 (85% male; 52% idiopathic dilated cardiomyopathy), treatment with low dose amiodarone (1000 mg/week) plus titrated doses of …