Document Detail

Acute electromechanical effects of atrioventricular coupled pacing in patients with heart failure.
MedLine Citation:
PMID:  18226771     Owner:  NLM     Status:  MEDLINE    
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.
Ronald Freudenberger; Mark Aaron; Steve Krueger; Melody Labeau; Karen Kleckner; Ruth Nicholson Klepfer
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  14     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-29     Completed Date:  2008-02-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  35-40     Citation Subset:  IM    
Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
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MeSH Terms
Cardiac Pacing, Artificial / methods*
Echocardiography, Doppler, Pulsed
Follow-Up Studies
Heart Failure / mortality,  therapy*,  ultrasonography*
Heart Function Tests
Hemodynamics / physiology*
Middle Aged
Prospective Studies
Risk Assessment
Severity of Illness Index
Single-Blind Method
Stroke Volume / physiology
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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