Influence of Closed-Loop Pacemaker Implantation on Patients' Quality of Life: RAPID Study Findings

Summary Unless carefully programmed, conventional open-loop rate-adaptive pacemakers may cause symptoms and impair quality of life (QOL) of the patients. Closed Loop Stimulation (CLS) systems regulate the pacing rate automatically based on the inotropic drive and allow the physician to program only the basic and maximum pacing rate. This study aimed to investigate the influence of automatic CLS rate adaptation on QOL of patients with different indications for pacing. Seventy-four patients from 14 clinical centers (mean age 71.5 ± 6.9 years, 36% female) with sick sinus syndrome (n = 37), atrioventricular block (n = 17), binodal disease (n = 16), and other indications for pacing (n = 4) filled out a QOL questionnaire before and at two instances (6-32 weeks) after implantation of a dual-chamber Inos 2 CLS pacemaker. Pacemaker application improved total QOL score by 14.7% (p < 0.001) in gross patient population and by 9.2%-20.8% in conjunction with different indications for pacing. QOL changes in gross population were highly significant (p < 0.001) in categories "Satisfaction" (+37.2%), "Mobility" (+29.1%) and "External activity" (+19.1%), significant (p < 0.05) in "Health" (+34.8%), "Moods" (+9.8%), "Social life" (+6.3%), "Appetite" (+15.8%) and "Housework" (+18.9%), and insignificant in "Self-confide nce" (+5.9%), "Autonomy" (+3.9%), "Job performance" (+12.0%) and "Sleep" (-3.6%). Too fast pacing rates during night were reported by two patients (2.7%), which required a reprogramming of the maximum pacing rate to a lower value or changing the pacing mode to DDD. In conclusion, patients with different indications for pacing benefited from dual-chamber CLS pacing in terms of improved QOL.