UVM researcher shows speeding up heart rate helps some heart failure patients

BURLINGTON, Vt. (WCAX) - A new study from a University of Vermont researcher shows some heart failure patients may benefit from a counterintuitive treatment approach.

Heart failure is when your heart doesn’t pump as well as it should. A 2021 study in the Journal of the American Heart Association says 5.4 million Americans have it and that it costs the health care system about $31 billion a year to manage. There are two kinds -- one where the heart muscle is too weak, and the other where it’s too stiff. The latest study in JAMA Cardiology looks at the stiff heart failure patients specifically.

Douglas Masson and his wife Suzanne enjoy their time together at their Cambridge home. It’s time that was nearly cut short in 2016 when Masson went to the doctor after feeling tired. His heart rate was just 32 beats per minute.

“And they put me in the back of an ambulance and sent me to the University of Vermont Medical Center where they did the pacemaker. It changed my life and saved my life,” Masson said.

The pacemaker allowed him to continue his active lifestyle, including his favorite hobby of skiing. But aside from that, there weren’t many other treatment options. “There are few effective therapies for patients with a stiff heart,” said Dr. Maggie Infeld, a cardiac electrophysiology fellow at the University of Vermont. She says about 50 to 80 percent of the three million Americans with stiff heart failure are on medications to slow their heart rate. The idea is to give the heart more time to fill up before pumping blood out. But she says there’s a growing body of research showing the medications might hurt, not help. “This can make patients feel worse and have less capacity for exercise.”

Her recent “MyPace” study took a different approach. Instead of slowing the patients’ resting heart rates, they increased them. Using specialized pacemakers like the one Masson has, they assigned either a personalized resting heart rate based on how many beats per minute they would have if their heart were healthy, or the standard pacemaker rate of 60 beats per minute. After a year, she says those with the individualized approach felt better. “The patients with the more personalized ‘normal’ heart rates had improvement in symptoms, improved pressures on their heart based on a lab test. They were more physically active and they had less atrial fibrillation,” Infeld said.

Masson was one of those patients for whom 60 beats per minute wasn’t enough. “I found that very low. My pacemaker was set at 80 and I felt good. And then they lowered it to 60 for a couple of days and that didn’t work,” he said.

Reporter Cat Viglienzoni: Describe what it feels like -- 60 versus 80 beats per minute for you.

Douglas Masson: I guess I could say it’s in slow motion and you just don’t have the energy or the get-up-and-go.

His pacemaker runs constantly now. At his bedside, he keeps a monitor that alerts doctors of any anomalies. It’s only ever gone off once, and the 78-year-old credits the technology with allowing him to continue to enjoy life to the beat of his own heart. “I can’t do all the things I want to do right now but I try my best. Life has been good,” Masson said.

Dr. Infeld cautions that the study has its limits. It cannot be done on patients with traditional pacemakers because the UVM ones are more specialized. And at just over 100 patients, it’s small-scale -- though she hopes other centers will replicate the findings in the future.

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