Journal of cardiac failure
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Multicenter Study
Treating heart failure with enhanced external counterpulsation (EECP): design of the Prospective Evaluation of EECP in Heart Failure (PEECH) trial.
Enhanced external counterpulsation (EECP) treatment can improve exercise tolerance in patients with ischemic heart disease; however, the possible benefits of EECP in patients with stable heart failure (HF) and left ventricular dysfunction (LVD) are unclear. An open pilot study showed significant increases in exercise tolerance in HF patients undergoing EECP. Thus a larger, controlled study of EECP in patients with stable HF (New York Heart Association [NYHA] classes II and III) and LVD was undertaken. ⋯ Efficacy measures include standard exercise tolerance tests on a treadmill (modified Naughton protocol), with measurements of peak oxygen uptake and exercise duration time; quality of life questionnaires; NYHA classification; and neurohormonal markers of HF.
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The incidence both of heart failure and atrial fibrillation is steadily increasing in the United States' population, and these conditions frequently coexist in the same patient. It is likely that the onset of one of these disorders leads to the onset and propagation of the other through multiple mechanisms. Several studies have investigated the prognosis of patients with both conditions, but a definitive conclusion regarding outcomes such as mortality and quality of life has yet to be determined. ⋯ Both retrospective and prospective studies of antiarrhythmic therapy and device therapy have demonstrated promising results. Several studies are ongoing and will provide more insight into the management of such patients.