Personalized Accelerated Pacing in HFpEF: Insights From the myPACE Follow-up

Heart failure with preserved ejection fraction (HFpEF) remains a therapeutic desert, with limited interventions improving outcomes. The myPACE randomized trial explored whether personalized accelerated pacing, raising resting rates above the conventional 60 bpm could reduce adverse clinical events. In an extended 4-year follow-up of 100 patients, intention-to-treat analyses showed only nonsignificant trends, but per-protocol analyses revealed striking benefits: slower accrual of clinical events (5 vs 31) and prolonged event-free survival (HR 0.30; 95% CI 0.11–0.80; P = .02). These findings, driven largely by reduced HF-related events, suggest that individualized pacing strategies may reshape management paradigms in HFpEF—but definitive evidence will require larger multicenter trials.

Is the conventional 60-bpm setting outdated? Click here to examine the full JAMA Cardiology paper. …