{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T03:27:13Z","timestamp":1781753233505,"version":"3.54.5"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":884,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T00:00:00Z","timestamp":1686528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although cardiac resynchronization therapy (CRT) improves functional capacity in heart failure patients, a blunted heart rate (HR) response remains after treatment. So we aimed to evaluate the feasibility of the physiological pacing rate (PPR) in CRT patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of 30 clinical mildly symptomatic CRT patients underwent the six-minute walk test (6MWT). During the 6MWT, HR, blood pressure, and maximum walking distance were assessed. The measurements were obtained in a pre to post manner, with CRT at nominal settings and with the physiological phase (CRT PPR), in which HR was increased by 10% above the maximum HR achieved previously. The CRT cohort also comprised a matched control group (CRT CG). In the CRT CG, the 6MWT was repeated after the standard evaluation with no PPR. The evaluations were blinded for patients and for the 6MWT evaluator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the 6MWT, CRT PPR led to an increase in walking distance of 40.5 m (9.2%; P &amp;lt; 0.0001) when compared with baseline trial. Additionally, CRT PPR increased the maximum walking distance compared with CRT CG 479.3 \u00b1 68.9 m vs. 420.3 \u00b1 44.8 m, respectively, P = 0.001. In the CRT CG, CRT PPR increased the variation in walking distance, compared with baseline trials, respectively 2.40 \u00b1 3.8% vs. 9.25 \u00b1 7.0%, P = 0.007.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In mildly symptomatic CRT patients PPR is feasible, leading to improvements in functional capacity. In this regard, the efficacy of PPR must be confirmed by controlled randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14429","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T10:40:01Z","timestamp":1686566401000},"page":"2751-2753","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Feasibility of Physiological Pacing Rate in Cardiac Resynchronization Therapy"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-1621","authenticated-orcid":false,"given":"Caio V.","family":"Spaggiari","sequence":"first","affiliation":[{"name":"Department of Artificial Cardiac Pacemaker Stimulation and Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio F.","family":"de Siqueira","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Pacemaker Stimulation and Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Parente","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Pacemaker Stimulation and Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinthya I.","family":"Guiar\u00e3o Gomes","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Pacemaker Stimulation and Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Janieire de N. N.","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Pacemaker Stimulation and Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martino Martinelli","family":"Filho","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Pacemaker Stimulation and Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,12]]},"reference":[{"key":"2026012114092374500_ehf214429-bib-0001","doi-asserted-by":"crossref","first-page":"2292","DOI":"10.1016\/j.jacc.2005.02.097","article-title":"The incremental benefit of rate-adaptive pacing on exercise performance during cardiac resynchronization therapy","volume":"46","author":"Tse","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2026012114092374500_ehf214429-bib-0002","doi-asserted-by":"crossref","first-page":"2591","DOI":"10.1111\/jce.14195","article-title":"Cardiac resynchronization therapy restores muscular metaboreflex control","volume":"30","author":"Spaggiari","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2026012114092374500_ehf214429-bib-0003","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ejheart.2007.11.006","article-title":"Chronotropic incompetence, beta-blockers, and functional capacity in advanced congestive heart failure: time to pace?","volume":"10","author":"Jorde","year":"2008","journal-title":"Eur J Heart Fail"},{"key":"2026012114092374500_ehf214429-bib-0004","first-page":"783","article-title":"The six-minute walk test","volume":"48","author":"Enright","year":"2003","journal-title":"Respir Care"},{"key":"2026012114092374500_ehf214429-bib-0005","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/01823246-201324030-00004","article-title":"Clinically meaningful change estimates for the six-minute walk test and daily activity in individuals with chronic heart failure","volume":"24","author":"Shoemaker","year":"2013","journal-title":"Cardiopulm Phys Ther J"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/4\/2751\/64704864\/eschf_10_4_2751.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/4\/2751\/64704864\/eschf_10_4_2751.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:10:06Z","timestamp":1769022606000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/10\/4\/2751\/8285334"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,12]]},"references-count":5,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,6,12]]},"published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14429","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,6,12]]},"assertion":[{"value":"2023-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}