Improvement of cardiac function with device-based diaphragmatic stimulation in chronic heart failure patients: The randomized, open-label, crossover Epiphrenic II Pilot Trial

  • Beeler R
  • Schoenenberger A
  • Bauer P
 et al. 
  • 7


    Mendeley users who have this article in their library.
  • N/A


    Citations of this article.


Aims: Device-based pacing-induced diaphragmatic stimulation (PIDS) may have therapeutic potential for chronic heart failure (HF) patients. We studied the effects of PIDS on cardiac function and functional outcomes. Methods and results: In 24 chronic HF patients with CRT, an additional electrode was attached to the left diaphragm. Randomized into two groups, patients received the following PIDS modes for 3 weeks in a different sequence: (i) PIDS off (control group); (ii) PIDS 0 ms mode (PIDS simultaneously with ventricular CRT pulse); or (iii) PIDS optimized mode (PIDS with optimized delay to ventricular CRT pulse). For PIDS optimization, acoustic cardiography was used. Effects of each PIDS mode on dyspnoea, power during exercise testing, and LVEF were assessed. Dyspnoea improved with the PIDS 0 ms mode (P =0.057) and the PIDS optimized mode (P =0.034) as compared with the control group. Maximal power increased from median 100.5 W in the control group to 104.0 W in the PIDS 0 ms mode (P =0.092) and 109.5 W in the PIDS optimized mode (P = 0.022). Median LVEF was 33.5% in the control group, 33.0% in the PIDS 0 ms mode, and 37.0% in the PIDS optimized mode (P = 0.763 and P=0.009 as compared with the control group, respectively). PIDS was asymptomatic in all patients. Conclusion PIDS improves dyspnoea, working capacity, and LVEF in chronic HF patients over a 3 week period in addition to CRT. This pilot study demonstrates proof of principle of an innovative technology which should be confirmed in a larger sample. © 2013 European Society of Cardiology.

Author-supplied keywords

  • NCT00769678
  • acoustic cardiography
  • adult
  • aged
  • angiotensin receptor antagonist
  • article
  • calcium channel blocking agent
  • cardiac resynchronization therapy
  • cardiac resynchronization therapy device
  • cardiography
  • clinical article
  • controlled study
  • crossover procedure
  • dipeptidyl carboxypeptidase inhibitor
  • diuretic agent
  • dyspnea
  • exercise test
  • female
  • heart failure
  • heart function
  • heart left ventricle failure
  • human
  • implantable cardioverter defibrillator
  • male
  • middle aged
  • pacemaker
  • pacing induced diaphragmatic stimulation
  • pilot study
  • priority journal
  • randomized controlled trial
  • spironolactone
  • therapy

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document


  • R Beeler

  • A W Schoenenberger

  • P Bauer

  • R Kobza

  • M Bergner

  • X Mueller

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free