Effect of functional electrical stimulation on cardiovascular outcomes in patients with chronic heart failure

• Published in: European journal of preventive cardiology 2017-05, Vol.24 (8), p.833-839
• Main Authors: Kadoglou, Nikolaos PE, Mandila, Christina, Karavidas, Apostolos, Farmakis, Dimitrios, Matzaraki, Vasiliki, Varounis, Christos, Arapi, Sofia, Perpinia, Anastasia, Parissis, John
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Chronic Disease; Disease Progression; Electric Stimulation Therapy - adverse effects; Electric Stimulation Therapy - methods; Electric Stimulation Therapy - mortality; Exercise Therapy - adverse effects; Exercise Therapy - methods; Exercise Therapy - mortality; Exercise Tolerance; Female; Heart Failure - diagnosis; Heart Failure - mortality; Heart Failure - physiopathology; Heart Failure - therapy; Hospitalization; Humans; Kaplan-Meier Estimate; Lower Extremity; Male; Middle Aged; Muscle Contraction; Prospective Studies; Quadriceps Muscle - innervation; Stroke Volume; Time Factors; Treatment Outcome; Ventricular Function, Left
• ISSN: 2047-4873; 2047-4881
• DOI: 10.1177/2047487316687428

Background/design Functional electrical stimulation of lower limb muscles is an alternative method of training in patients with chronic heart failure (CHF). Although it improves exercise capacity in CHF, we performed a randomised, placebo-controlled study to investigate its effects on long-term clinical outcomes. Methods We randomly assigned 120 patients, aged 71 ± 8 years, with stable CHF (New York Heart Association (NYHA) class II/III (63%/37%), mean left ventricular ejection fraction 28 ± 5%), to either a 6-week functional electrical stimulation training programme or placebo. Patients were followed for up to 19 months for death and/or hospitalisation due to CHF decompensation. Results At baseline, there were no significant differences in demographic parameters, CHF severity and medications between groups. During a median follow-up of 383 days, 14 patients died (11 cardiac, three non-cardiac deaths), while 40 patients were hospitalised for CHF decompensation. Mortality did not differ between groups (log rank test P = 0.680), while the heart failure-related hospitalisation rate was significantly lower in the functional electrical stimulation group (hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.21–0.78, P = 0.007). The latter difference remained significant after adjustment for prognostic factors: age, gender, baseline NYHA class and left ventricular ejection fraction (HR 0.22, 95% CI 0.10–0.46, P