P-117 Correlation between closed-loop stimulation (CLS), cardiopulmonary capacity and quality of life

Abstract Aims Reflex vasovagal syncope (VVS) is the most common cause of syncope and patients with recurrent episodes may severely impair quality of life (QoL). This pre-specified analysis evaluated whether the clinically significant reduction in syncope burden demonstrated by dual-chamber pacing with closed loop stimulation (DDD-CLS) reported in the SPAIN trial translates into improved QoL. Methods and results Patients aged ≥40 years with ≥5 VVS episodes and cardioinhibitory response induced by head-up tilt testing were included. Patients were randomized 1:1 to active DDD-CLS pacing algorithm for 12 months followed by sham DDI mode for the remaining 12 months (Group A) or vice versa (Group B). QoL was assessed using the Short Form-36 (SF-36) health survey, Physical Component Score (PCS), and Mental Component Score (MCS) before randomization (baseline) and at 12- and 24-month follow-up. Fifty-four patients were enrolled from 11 participating centres. No significant carryover effect was detected for any variable, and the only period effect was observed in the vitality subdomain (P = 0.033). Mean SF-36 scores were higher in the DDD-CLS group vs. the DDI group for the eight subdomains and significantly different in physical role, bodily pain, and vitality (P < 0.05). The analysis of component summary scores indicated that DDD-CLS benefited both mental and physical components with significant differences in PCS when compared with the DDI group. Conclusion Dual-chamber pacing with closed loop stimulation determined a significant and clinically relevant improvement in QoL across both mental and physical components in patients with recurrent VVS. Registration Closed Loop Stimulation for Neuromediated Syncope (SPAIN Study); NCT01621464.

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P-117 Correlation between closed-loop stimulation (CLS), cardiopulmonary capacity and quality of life

EP Europace ◽

10.1016/eupace/4.supplement_2.b94-a ◽

2003 ◽

Vol 4 (Supplement_2) ◽

pp. B94-B94

Author(s):

A.S. Menezes ◽

H.G. Moreira ◽

M.T. Daher

Keyword(s):

Quality Of Life ◽

Closed Loop ◽

Closed Loop Stimulation

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Closed loop stimulation and quality of life. Results of the Italian “rapid” trial

EP Europace ◽

10.1016/eupace/2.supplement_1.a63-a ◽

2001 ◽

Vol 2 (Supplement_1) ◽

pp. A63-A63

Author(s):

M. Santomauro ◽

A. Morrone ◽

F. Zolezzi ◽

A. Galati ◽

A. Filice ◽

...

Keyword(s):

Quality Of Life ◽

Closed Loop ◽

Closed Loop Stimulation

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2167Impact of dual-chamber pacing with closed loop stimulation on quality of life in patients with recurrent reflex vasovagal syncope: results from the SPAIN study

European Heart Journal ◽

10.1093/eurheartj/ehz748.0095 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

G Baron Esquivias ◽

C M Morillo ◽

A M Moya ◽

J D Martinez Alday ◽

R Ruiz-Granell ◽

...

Keyword(s):

Quality Of Life ◽

Closed Loop ◽

Vasovagal Syncope ◽

P Value ◽

Dual Chamber ◽

Double Blind ◽

Sf 36 ◽

Closed Loop Stimulation

Abstract Background Reflex vasovagal syncope (VVS) is one of the most common causes of syncope and, when recurrent, can have devastating consequences on the quality of life of patients despite pharmacological interventions. The closed loop stimulation (CLS) pacing algorithm converts, during an incipient VVS, variations in right intracardiac impedance into heart rate adaptation. The study SPAIN was the first randomized, double-blind trial robustly showing a strong reduction in syncopal recurrence in patients paced with dual-chamber (DDD)-CLS. (NCT01621464). Purpose To evaluate whether the differences observed in the SPAIN study regarding syncope burden and time to recurrence translate into improvements on quality of life. Methods This study analysed quality of life data from the SPAIN study: a randomized, prospective, double-blind, multicenter trial conducted in 10 Spanish and 1 Canadian centers. Ethics Committee approval was obtained at each participating center. Patients aged ≥40 years, with ≥5 VVS episodes and cardioinhibitory response to head-up tilt testing were included. After implant, patients were randomized 1:1 to active DDD-CLS mode for 12 months followed by sham DDI mode for the remaining 12 months or vice-versa. Quality of life was assessed via the Short Form-36 (SF-36) health survey before randomization (baseline), and at 12- and 24-month follow-up. The change in quality of life during the entire follow-up relative to baseline was compared between each pacing mode (DDD-CLS vs. DDI). Results Fifty-four patients were enrolled with a mean age of 56.3±10.6 years and a median of 12 syncopal episodes before randomization. Median SF-36 scores greatly increased from baseline in the DDD-CLS group across the 8 domains, whereas the response was variable in the DDI group. Comparing both pacing algorithms, median SF-36 scores were higher in the DDD-CLS group, with differences reaching statistical significance for “physical role” and “vitality” domains (p-value =0.006 and 0.014, respectively). Pacing sequence or treatment period did not significantly influence the response (p-value >0.05 for all the domains). Conclusions We demonstrated the beneficial effect of this physiological pacing algorithm on the quality of life of patients, as evidenced by the improvement in all the domains of the SF-36 when stimulated in DDD-CLS as compared to the sham DDI mode.

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Injectable self-assembled peptide hydrogels for glucose-mediated insulin delivery

Biomaterials Science ◽

10.1039/c8bm00006a ◽

2018 ◽

Vol 6 (6) ◽

pp. 1480-1491 ◽

Cited By ~ 12

Author(s):

Mian Fu ◽

Chenyu Zhang ◽

Yuxuan Dai ◽

Xue Li ◽

Miaobo Pan ◽

...

Keyword(s):

Quality Of Life ◽

Closed Loop ◽

Insulin Delivery ◽

Diabetic Patients ◽

Self Assembled ◽

Peptide Hydrogels

Closed-loop glucose-responsive insulin delivery with excellent biocompatibility has the potential to improve the health and quality of life of diabetic patients.

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P1547THE EFFECT OF INTERNET-BASED CLOSED-LOOP MANAGEMENT ON QUALITY OF LIFE IN PATIENTS ON PERITONEAL DIALYSIS, A SELF-CONTROL STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1547 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Fang Cao

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Management System ◽

Closed Loop ◽

Health Management ◽

Management Model ◽

Self Management ◽

Dialysis Patients

Abstract Background and Aims With the continuous advancement of information technology, mobile Internet has entered every family and shown its unique advantages. The development of hospital's information construction on the management of chronic disease, the continuous improvement of hospital APP and Wechat public number functions have provided intelligent services for patients throughout the process. Along with this process, the way of hospital patient follow-up has gradually expanded and improved, and the automation and intellectualization of follow-up work has become a reality. However, The establishment of peritoneal dialysis health management professional team and the implementation of closed-loop health management model, which is based on the Internet closed-loop management model has no clear impact on the self-management ability, quality of life and treatment effect of peritoneal dialysis patients. To explore the effectiveness of Internet based in-hospital and out of hospital closed loop management on the quality of life of patients with peritoneal dialysis, it is necessary to establish a set of closed loop management system for chronic diseases patients with promotion and practical significance. Method From July 2017 to July 2018, 214 patients with continuous peritoneal dialysis were followed up regularly in the Department of Nephrology of our hospital, and voluntarily participated in this study. The mean follow-up time was 12.6 ± 1.5 months. The differences of blood electrolytes, quality control indexes, self-management ability, quality of life of renal disease and hospital satisfaction were observed before and after closed-loop management. Results Ability of self-management behavior (p < 0.001), quality of life (p < 0.001), satisfaction (p < 0.001), the incidence of infection (p < 0.05), serum albumin (p < 0.05), hemoglobin (p < 0.05)were improved after participating in the closed-loop management. Conclusion The closed-loop management system based on Internet closed-loop management model is effective for the quality of life and treatment effect of peritoneal dialysis patients, which integrates the core functions of follow-up records, intelligent early warning, doctor-patient communication and health education. Through this closed-loop management, medical staff can digitally collect, store, transmit and process the information of in-hospital and out-of-hospital conditions through follow-up analysis, health guidance and remote assistance to achieve the purpose of patient health management. This study shows that this closed-loop management system can effectively manage the health of peritoneal dialysis patients, and provides a replicable model for the management of chronic diseases. Therefore, a comprehensive closed-loop management system based on mobile Internet and information technology, with clinical care as the leading factor and peritoneal dialysis patients as the terminal is a feasible and acceptable follow-up management method for peritoneal dialysis patients and hospitals.

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