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CRT may make heart patients 'sharper'.

DENVER -- Cardiac resynchronization therapy not only reduces mortality and improves quality of life in heart failure patients, it also appears to enhance their cognitive function to a clinically meaningful degree, Neha K. Dixit reported at the annual meeting of the Heart Rhythm Society.

She presented a 20-patient pilot study that documented significant improvements, specifically in the domains of attention and information processing 3 months following implantation of a biventricular pacemaker for cardiac resynchronization therapy (CRT). Both domains are part of what psychologists call executive function.

"We saw differences in specific tasks that require vigilance and attention and information processing speed. These are differences of a degree that patients and their families would notice," she said in an interview.

Study participants underwent a 40-minute battery of brief neurocognitive tests and measures of psychosocial function 24 hours prior to and again 3 months after device implantation.

Mean scores on the Wechsler Adult Intelligence Scale-3rd Edition digit span test--a measure of attention--increased from a mean of 55.9 to 62.3, while information processing as assessed by the Wechsler Digit Symbol Test improved from 46.5 to 54.5. Heart failure-specific quality of life as measured by the Minnesota Living with Heart Failure Questionnaire also improved significantly.

The proposed mechanism of neurocognitive benefit is enhanced cerebral blood flow as a result of improved cardiac function owing to CRT, according to Ms. Dixit, a PhD student in clinical and health psychology at the University of Florida, Gainesville. "We're seeing changes in the areas of the brain that would be most susceptible to lack of perfusion," she said.

There was no change in verbal memory following initiation of CRT. Study participants did not have clinical depression or anxiety before or after device implantation.

Anecdotally, before CRT, many heart failure patients would complain of feeling fuzzy. "Post CRT they felt better. They'd say, 'I feel a little sharper, names are coming to me quicker'--that sort of thing," Ms. Dixit said.
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Title Annotation:Across Specialties
Author:Jancin, Bruce
Publication:Clinical Psychiatry News
Date:Mar 1, 2008
Words:324
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