Short-Term and Long-Term Changes of Left Ventricular Volumes During Rate-Adaptive and Single-Rate Pacing
| Autor: | J. A. K. Blokland, Jeeerey D. Adipranoto, Albert V.G. Bruschke, M I Sedney, Eric Weijers, Johannes J. Schipperheijn, Beert Buis, J. A. J. Camps, Ernst E. van der Wall, Ernest K. J. Pauwels |
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| Rok vydání: | 1989 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Cardiac Volume Heart Ventricles Volume change Supination Contractility Radionuclide angiography Internal medicine medicine Humans Left ventricular dilatation cardiovascular diseases Radionuclide Imaging Exercise Aged Ejection fraction medicine.diagnostic_test Ventricular function business.industry Cardiac Pacing Artificial Stroke Volume General Medicine Middle Aged Left ventricular contractility Adaptation Physiological Cardiology Female Maximal exercise Cardiology and Cardiovascular Medicine business |
| Zdroj: | Pacing and Clinical Electrophysiology. 12:1863-1868 |
| ISSN: | 1540-8159 0147-8389 |
| DOI: | 10.1111/j.1540-8159.1989.tb01877.x |
| Popis: | SEDNEY, M.L, et al.: Short-Term and Long-Term Changes of Left Ventricular Volumes During Rate-Adaptive and Single-Rate Pacing To evaluate the adaptation of the heart to exercise during pacing, 15 patients with permanent endocardial pacemakers were studied; nine patients had atrioventricular universal (DDD) pacemakers (Symbios 7005) and six patients had activity detecting rate-responsive ventricular (WIR) pacemakers (Activitrax 8403). Left ventricular function in each patient during rate variable pacing was compared to ventricular function during VVI single-rate pacing. End-systolic and end-diastolic volume changes during exercise were measured by radionuclide angiography and the amount of volume change was used to assess left ventricular function. Both short-term (within 4 hours) and long-term measurements (after at least 4 weeks) were made at rest and at 50% of the maximal exercise capacity in DDD or VVIR mode and were compared with VVI single-rate pacing. All patients, when changed from DDD or VVIR mode to VVI single-rate pacing showed a significant increase of the end-diastolic volume during exercise, which increased even more after long-term VVI pacing. During long-term rate variable pacing, there was no increase of the end-diastolic volume during exercise. DDD or VVIR pacing initially showed a substantial increase of the end-systolic volume during exercise combined with a decrease of left ventricular ejection fraction, suggesting a decrease of the left ventricular contractility. After 4 weeks, contractility improved both with DDD and VVIR pacing. We conclude that short-term DDD and VVIR pacing induces a temporary impairment of left ventricular function that improves after 4 weeks, whereas long-term VVI pacing is associated with left ventricular dilatation even at moderate levels of exercise. |
| Databáze: | OpenAIRE |
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