Summary
To assess the effects of the various modes of physiological pacing on left ventricular volume and hemodynamics, we studied 12 pts (age 52 ± 4 yrs) who had intramyocardial tantalum markers implanted at the time of coronary bypass surgery: Left ventricular (LV) end-diastolic volume (EDV) and ejection fraction (EF) were determined from cinefluoroscopic tantalum marker ventriculograms, validated with contrast angiography.
Thermodilution cardiac output (CO) and LV systolic pressure (LVSP) were recorded at rest and after 2 min of pacing, in atrial (AP), ventricular (VP), and A-V sequential (AVP) modes with varying A-V intervals (AVI) and pacing rates (HR). Results were as follows:
LVSP decreased with VP, as compared to AP and AVP (p < 0.05). EF did not differ amongst the different modes and rates of pacing.
Conclusion: 1. Compared to AP and AVP, VP produced adverse effects on LV hemodynamics with decreases in CO and LVSP; 2. CO decreased during VP, but EDV and EF did not change significantly, implying that the decrease in CO was due to asynchronous ventricular contraction with possible mitral regurgitation; 3. There were no significant differences in LV volume and hemodynamics between AP and AVP at various AVI; 4. These data support the functional benefits of physiological pacing.
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© 1983 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt
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Liu, P., Bums, R.J., Weisel, R.D., Mickleborough, L., Goldman, B.S., McLaughlin, P.R. (1983). Comprehensive Evaluation of Ventricular Function During Physiological Pacing. In: Steinbach, K. (eds) Cardiac Pacing. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-72367-4_33
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DOI: https://doi.org/10.1007/978-3-642-72367-4_33
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