New Research to Study Benefits of Personalised Pacemaker Programming

Researchers BHF have funded at the University of Leeds will investigate how people living with heart failure can benefit from personalised pacemaker programming.

Heart failure is an incurable condition, in which the heart cannot pump blood around the body as well as it should. As many as 920,000 people across the UK are living with this condition, which can be debilitating and result in symptoms of breathlessness and fatigue – making everyday activities and exercise more difficult.

Patient benefits

For some patients living with heart failure, a pacemaker will be implanted to help retune the pumping function of the heart. Pacemakers are programmed using a default algorithm to increase the heart rate during exercise.

However, the team at the University of Leeds have shown that this ‘one size fits all’ algorithm does not always improve a person’s ability to exercise. They believe it could be because this algorithm is based on the heart rate that would be expected in healthy individuals.

Researchers have discovered that by instead personalising this heart rate to the patient, they can improve how well people can exercise.

Improving function of the heart

BHF have now awarded almost £260,000 for a new trial to assess how this approach improves function of the heart and exercise capacity. The trial, which launches this month at the NIHR Cardiovascular Clinical Research Facility at Leeds General Infirmary, will involve around 100 patients who will be randomly allocated to have their pacemakers programmed in three different ways.

The first group will have the standard algorithm, whilst the second group will have the algorithm turned off. A third group will have their pacemaker personalised for their heart. Participants will then be reassessed after six months to see what effects personalised programming has had.

Promising early studies

Klaus Witte, Associate Professor at University of Leeds and Consultant Cardiologist at Leeds Teaching Hospitals NHS Trust, said: “Personalised programming is a new, safe and inexpensive approach to managing the heart rate of people living with heart failure.

“For those living with pacemakers, even modest improvements in exercise capacity and symptoms can have dramatic effects on self-confidence, independence and quality of life. Our early research has found that this could also really benefit their hearts by helping to slow down deterioration of heart function.

“This research will help us understand how personalised programming works and whether this is due to changes in the body’s automatic stress system or the heart’s blood supply. The findings could help guide the development of a larger, multi-centre study, which could ultimately change the way we think about treating people living with heart failure.”

Dr Noel Faherty, Senior Research Adviser at the BHF, added: “Heart failure is a chronic condition that has no cure, so improved treatments are needed to ensure people living with this condition can have a better quality of life.

“Pacemakers are life saving, but there is a lack of guidance around how heart failure patients living with these devices can exercise most effectively. Promising early studies have shown the benefits of personalised programming, so this research could provide new answers which could help patients live well for longer.”

Anne’s story

Anne Dixon, aged 67, had a heart attack in 2011 and was diagnosed with heart failure two years later. Anne lives with a pacemaker, and has experienced several benefits after her pacemaker received personalised programming.

Anne, who lives in York and has three grown up children, said: “Life has been a rollercoaster since my heart attack and there have been times where I’ve barely been able to walk 500 metres.

“Now, I’m able to do so much more than I could before. When I go to the gym, I’m able to exercise longer. I’m also a fan of hill walking and used to struggle to walk a mile. I find now that I can go even further without getting out of breath.

“It’s made such a difference to my life and helped improve my confidence, too. I’m delighted that the BHF is funding more research to understand the true benefits of personalised programming, as it could really help patients like me in the future.”