Acute electromechanical effects of atrioventricular coupled pacing in patients with heart failure.

Autor: Freudenberger R; Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA., Aaron M, Krueger S, Labeau M, Kleckner K, Klepfer RN
Jazyk: angličtina
Zdroj: Journal of cardiac failure [J Card Fail] 2008 Feb; Vol. 14 (1), pp. 35-40.
DOI: 10.1016/j.cardfail.2007.09.003
Abstrakt: Background: Postextrasystolic potentiation (PESP) is a property of cardiac tissue whereby two closely timed depolarizations cause the subsequent contraction to be of increased magnitude.
Methods and Results: Ten subjects were studied in a single-blind study to evaluate the safety and performance of an atrioventricular coupled pacing (A-VCP) algorithm to produce sustained PESP among subjects with moderate heart failure. The primary end points were algorithm safety, patient perception, and cardiac function. The effects of A-VCP on cardiac function were assessed by comparing echocardiographic parameters before and after 15 to 20 minutes of A-VCP. A-VCP produced no arrhythmic episodes, ejection fraction increased by 8 ejection fraction points (31%) (P < or = .001), end-systolic volume decreased by 10% (P < or = .05), and a trend toward increasing end-diastolic volume was observed (P = .084). Stroke volume increased by 43% (P < or = .001), and the pulse rate decreased by 41% (P < or = .001) during A-VCP. This resulted in decreased cardiac output of 15% (P < or = .05). Six of the 10 subjects felt no effects from A-VCP, and four subjects felt a change with A-VCP turned on.
Conclusion: Short-term A-VCP was found to be safe and well tolerated in a majority of patients. Hemodynamic effects were mixed with improved ejection fraction and stroke volume but decreased cardiac output.
Databáze: MEDLINE
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