{
  "abstract": "Background\n\nExercise intolerance and poor quality of life remain challenges in HFpEF, driven by chronotropic incompetence and left atrial dysfunction. We evaluated whether rate-adaptive/accelerated pacing (RAAP), targeting these mechanisms, improves hemodynamic, functional, and patient-reported outcomes.Methods\n\nPubMed, Embase, and the Cochrane Library were searched. Outcomes included NT-proBNP, Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, 6-min walk distance (6MWD), E/e', and E/A. Within-group pre-post changes and comparisons with usual care were synthesized separately. Effects are reported as mean differences (MD) or odds ratios (OR) with 95% confidence intervals (CI).Results\n\nEight reports involving 380 patients were included with myPACE overlap handled by one report per cohort per analysis. Within-group, RAAP was associated with reductions in NT-proBNP (MD -462.58 pg/mL; 95% CI -891.37 to -33.79), E/A (MD -1.01; -1.19 to -0.83), and E/e' (MD -3.18; -5.65 to -0.72), and improvements in 6MWD (MD +74.10 m; 36.34 to 111.86) and MLHFQ score (MD -17.40 points; -33.06 to -1.74). Compared with usual care, associations favored RAAP for NT-proBNP (MD -108.51 pg/mL; -118.31 to -98.70), 6MWD (MD +73.36 m; 32.23 to 114.48), MLHFQ score (MD -16.52 points; -24.15 to -8.89), and AF burden (MD -6.13; -7.88 to -4.37). MACE also favored RAAP in an exploratory analysis (OR 0.47; 0.23 to 0.93), whereas peak VO₂ did not differ significantly.Conclusions\n\nRAAP was associated with favorable changes in hemodynamic and functional outcomes. These findings support further evaluation of individualized rate modulation in adequately powered randomized trials.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology and Vascular Medicine Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital Denpasar Bali Indonesia.",
    "Clinical Clerkship Program, Faculty of Medicine Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah Central General Hospital Denpasar Bali Indonesia."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Gusti Ngurah Prana Jagannatha",
      "orcid": "0000-0001-7371-4520"
    },
    {
      "affs": [
        0
      ],
      "name": "David Yobel",
      "orcid": "0000-0003-1349-1091"
    },
    {
      "affs": [
        1
      ],
      "name": "Christo Timothy Mamangdean",
      "orcid": "0000-0001-8033-5756"
    },
    {
      "affs": [
        0
      ],
      "name": "Bagus Made Indrata Saputra"
    },
    {
      "affs": [
        0
      ],
      "name": "Anak Agung Ayu Dwi Adelia Yasmin",
      "orcid": "0000-0003-2705-9312"
    },
    {
      "affs": [
        0
      ],
      "name": "I Nyoman Wiryawan",
      "orcid": "0009-0006-0566-6022"
    },
    {
      "affs": [
        0
      ],
      "name": "I Made Putra Swi Antara",
      "orcid": "0000-0002-1865-4163"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2867tnp5zzkm7.bib",
  "cited_by": 0,
  "doi": "10.1002/joa3.70504",
  "fulltext_url": "https://europepmc.org/articles/PMC13694742",
  "id": "2867tnp5zzkm7",
  "issns": [
    "1880-4276",
    "1883-2148"
  ],
  "landing_url": "https://europepmc.org/article/MED/42927126",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Cardiac pacing and defibrillation studies"
    ]
  ],
  "openalex": "W7223465929",
  "pdf_url": "https://europepmc.org/articles/PMC13694742?pdf=render",
  "pmcid": "PMC13694742",
  "pmid": "42927126",
  "published": "2026-10-23",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2867tnp5zzkm7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42927126",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42927126"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac pacing and defibrillation studies",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Hemodynamic and Functional Outcomes of Rate-Adaptive and Physiologic Pacing in Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-Analysis.",
  "title_text": "Hemodynamic and Functional Outcomes of Rate-Adaptive and Physiologic Pacing in Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-Analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/2867tnp5zzkm7",
  "venue": "Journal of arrhythmia",
  "versions": []
}