{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:51:10Z","timestamp":1781074270439,"version":"3.54.1"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["ICA-CDRF-2016-02-055"],"award-info":[{"award-number":["ICA-CDRF-2016-02-055"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Pacemakers are widely utilised to treat bradycardia, but right ventricular (RV) pacing is associated with heightened risk of left ventricular (LV) systolic dysfunction and heart failure. We aimed to compare personalised pacemaker reprogramming to avoid RV pacing with usual care on echocardiographic and patient-orientated outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>A prospective phase II randomised, double-blind, parallel-group trial in 100 patients with a pacemaker implanted for indications other than third degree heart block for \u22652 years. Personalised pacemaker reprogramming was guided by a published protocol. Primary outcome was change in LV ejection fraction on echocardiography after 6 months. Secondary outcomes included LV remodeling, quality of life, and battery longevity.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Clinical and pacemaker variables were similar between groups. The mean age (SD) of participants was 76 (+\/-9) years and 71% were male. Nine patients withdrew due to concurrent illness, leaving 91 patients in the intention-to-treat analysis. At 6 months, personalised programming compared to usual care, reduced RV pacing (-6.5\u00b11.8%<jats:italic>versus<\/jats:italic>-0.21\u00b11.7%; p&lt;0.01), improved LV function (LV ejection fraction +3.09% [95% confidence interval (CI) 0.48 to 5.70%; p = 0.02]) and LV dimensions (LV end systolic volume indexed to body surface area -2.99mL\/m<jats:sup>2<\/jats:sup>[95% CI -5.69 to -0.29; p = 0.03]). Intervention also preserved battery longevity by approximately 5 months (+0.38 years [95% CI 0.14 to 0.62; p&lt;0.01)) with no evidence of an effect on quality of life (+0.19, [95% CI -0.25 to 0.62; p = 0.402]).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Personalised programming in patients with pacemakers for bradycardia can improve LV function and size, extend battery longevity, and is safe and acceptable to patients.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Trial registration<\/jats:title><jats:p>ClinicalTrials.gov identifier:<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03627585\" xlink:type=\"simple\">NCT03627585<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0259450","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T18:31:15Z","timestamp":1639420275000},"page":"e0259450","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Personalised reprogramming to prevent progressive pacemaker-related left ventricular dysfunction: A phase II randomised, controlled clinical trial"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8517-4621","authenticated-orcid":true,"given":"Maria F.","family":"Paton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gierula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith E.","family":"Lowry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Cairns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"Bose Rosling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte A.","family":"Cole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"McGinlay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Straw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowena","family":"Byrom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M.","family":"Cubbon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T.","family":"Kearney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus K.","family":"Witte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"issue":"16","key":"pone.0259450.ref001","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1056\/NEJM199804163381602","article-title":"Quality of life and clinical outcomes in elderly patients treated with ventricular pacing as compared with dual-chamber pacing","volume":"338","author":"G.A. Lamas","year":"1998","journal-title":"New England Journal of Medicine"},{"issue":"8","key":"pone.0259450.ref002","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1111\/j.1540-8159.2011.03150.x","article-title":"The 11th world survey of cardiac pacing and implantable cardioverter-defibrillators: calendar year 2009\u2013a World Society of Arrhythmia\u2019s project","volume":"34","author":"H.G. Mond","year":"2011","journal-title":"Pacing and clinical electrophysiology"},{"issue":"6","key":"pone.0259450.ref003","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1016\/0002-8703(90)90055-3","article-title":"Epidemiologic aspects of heart failure","volume":"120","author":"G.C. Sutton","year":"1990","journal-title":"American heart journal"},{"issue":"11","key":"pone.0259450.ref004","doi-asserted-by":"crossref","first-page":"743","DOI":"10.2459\/JCM.0000000000000117","article-title":"Patients with long-term permanent pacemakers have a high prevalence of left ventricular dysfunction","volume":"16","author":"J. Gierula","year":"2015","journal-title":"Journal of Cardiovascular Medicine"},{"issue":"9","key":"pone.0259450.ref005","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1016\/j.jacc.2004.06.074","article-title":"Left ventricular function during and after right ventricular pacing","volume":"44","author":"M. Nahlawi","year":"2004","journal-title":"Journal of the American College of Cardiology"},{"issue":"3","key":"pone.0259450.ref006","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1093\/europace\/eun010","article-title":"Potential role of remote monitoring for scheduled and unscheduled evaluations of patients with an implantable defibrillator","volume":"10","author":"H. Heidb\u00fcchel","year":"2008","journal-title":"Europace"},{"issue":"10","key":"pone.0259450.ref007","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1136\/heartjnl-2013-304905","article-title":"Pacing-associated left ventricular dysfunction? Think reprogramming first!","volume":"100","author":"J. Gierula","year":"2014","journal-title":"Heart"},{"key":"pone.0259450.ref008","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1056\/NEJM198710223171717","article-title":"Simplified calculation of body surface area","volume":"317","author":"R. Mosteller","year":"1987","journal-title":"N Engl J Med"},{"key":"pone.0259450.ref009","unstructured":"NICE, Dual-chamber pacemakers for symptomatic bradycardia due to sick sinus syndrome and\/or atrioventricular block. 2017."},{"key":"pone.0259450.ref010","unstructured":"BHRS, British Heart Rhythm Society Clinical Guidance for the Follow-up of Cardiac Implantable Electronic Devices for Cardiac Rhythm Management. 2015."},{"issue":"10","key":"pone.0259450.ref011","first-page":"e002962","article-title":"Changes in left ventricular ejection fraction predict survival and hospitalization in heart failure with reduced ejection fraction","volume":"9","author":"K. Breathett","year":"2016","journal-title":"Circulation: Heart Failure"},{"issue":"6","key":"pone.0259450.ref012","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1161\/01.CIR.98.6.588","article-title":"Asynchronous electrical activation induces asymmetrical hypertrophy of the left ventricular wall","volume":"98","author":"M.F. Van Oosterhout","year":"1998","journal-title":"Circulation"},{"issue":"5","key":"pone.0259450.ref013","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jacc.2010.05.011","article-title":"Quantitative Evaluation of Drug or Device Effects on Ventricular Remodeling as Predictors of Therapeutic Effects on Mortality in Patients With Heart Failure and Reduced Ejection Fraction: A Meta-Analytic Approach","volume":"56","author":"D.G. Kramer","year":"2010","journal-title":"Journal of the American College of Cardiology"},{"issue":"suppl_5","key":"pone.0259450.ref014","doi-asserted-by":"crossref","first-page":"v58","DOI":"10.1093\/europace\/eup308","article-title":"What is treatment success in cardiac resynchronization therapy?","volume":"11","author":"P.W. Foley","year":"2009","journal-title":"Europace"},{"issue":"2","key":"pone.0259450.ref015","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1540-8167.2007.01014.x","article-title":"New-onset heart failure after permanent right ventricular apical pacing in patients with acquired high-grade atrioventricular block and normal left ventricular function","volume":"19","author":"X.H. Zhang","year":"2008","journal-title":"Journal of cardiovascular electrophysiology"},{"issue":"44","key":"pone.0259450.ref016","doi-asserted-by":"crossref","first-page":"3641","DOI":"10.1093\/eurheartj\/ehz584","article-title":"Incidence of heart failure after pacemaker implantation: a nationwide Danish Registry-based follow-up study","volume":"40","author":"B. Tayal","year":"2019","journal-title":"European heart journal"},{"key":"pone.0259450.ref017","article-title":"Pacemaker battery scandal","author":"J. Dean","year":"2016","journal-title":"British Medical Journal Publishing Group"},{"issue":"9 Suppl","key":"pone.0259450.ref018","first-page":"II245","article-title":"Reprogramming pacemakers enhances longevity and is cost-effective","volume":"94","author":"G.H. Crossley","year":"1996","journal-title":"Circulation"},{"issue":"9","key":"pone.0259450.ref019","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1002\/clc.4960120907","article-title":"Symptomatology and quality of life in patients with rate-responsive pacemakers: A double-blind, randomized, crossover study","volume":"12","author":"C.P. Lau","year":"1989","journal-title":"Clinical cardiology"},{"issue":"29","key":"pone.0259450.ref020","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.1093\/eurheartj\/eht150","article-title":"2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)","volume":"34","author":"M. 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