Sustained sympathoinhibitory effects of cardiac resynchronization therapy in severe heart failure

Guido Grassi, Antonio Vincenti, Roberta Brambilla, Fosca Quarti Trevano, Raffaella Dell'Oro, Antonio Cirò, Giuseppe Trocino, Antonella Vincenzi, Giuseppe Mancia

Research output: Contribution to journalArticlepeer-review


Evidence is available that in heart failure, cardiac resynchronization therapy by biventricular pacing improves myocardial function and exercise capacity. Whether this is accompanied by a sustained inhibition of heart failure-dependent sympathoexcitation is uncertain. In 11 heart failure patients (mean±SEM age, 68.4±1.5 years) in New York Heart Association (NYHA) class III and IV under medical treatment with an intraventricular conduction delay (QRS duration ≥130 ms), with a markedly depressed left ventricular ejection fraction, and undergoing implantation of a biventricular pacemaker, we measured beat-to-beat blood pressure and muscle sympathetic nerve traffic. Measurements, which also included echocardiographic and clinical variables, were performed before and ≈10 weeks after successful resynchronization therapy. Ten age- and NYHA class-matched heart failure patients who were under medical treatment for the same time period served as controls. Long-term resynchronization therapy improved cardiac function and caused a significant increase in systolic blood pressure coupled with an improvement in maximal oxygen consumption and exercise capacity. These effects were coupled with a significant and marked reduction in sympathetic nerve traffic when expressed both as burst frequency over time (44.1±3.6 vs 30.7±3.0 bs/min, -30.5%, P

Original languageEnglish
Pages (from-to)727-731
Number of pages5
Issue number5
Publication statusPublished - Nov 2004


  • Autonomic nervous system
  • Electrical stimulation
  • Heart failure
  • Sympathetic nervous system

ASJC Scopus subject areas

  • Internal Medicine


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