Document Detail

Acute hemodynamic effects of different atrioventricular intervals in dual chamber pacemakers: is there an optimum atrioventricular delay.
MedLine Citation:
PMID:  1427936     Owner:  NLM     Status:  MEDLINE    
Conflicting data have been reported regarding adjustment of atrioventricular (AV) interval to maximise hemodynamic performance of dual chamber pacemakers. Eleven consecutive patients with complete heart block and dual chamber pacemakers were paced at three AV intervals (150, 200, 250 msec) and free running rates (60-93 bpm, mean 73 +/- 12 bpm) with simultaneous measurements of cardiac output, atrial contribution to left ventricular filling, left ventricular ejection fraction, and peak aortic velocity and acceleration by echo-Doppler techniques to define the optimum AV delay. At all the three AV intervals tested there was no difference in cardiac output (4.7 +/- 0.96, 4.83 +/- 1.12, 4.77 +/- 1.19 litres/min respectively, p = NS), left ventricular ejection fraction (60.2 +/- 10.6%, 61.2 +/- 9.9% and 64 +/- 8.3%, p = NS), atrial contribution to left ventricular filling (0.37 +/- 0.10, 0.38 +/- 0.09, 0.36 +/- 0.16, n = 8, p = NS), peak aortic velocity (104 +/- 8, 105 +/- 12, 104 +/- 13 cm/sec, p = NS) and aortic acceleration (19.68 +/- 4.26, 20.4 +/- 5.58 and 19.0 +/- 4.54 m/sec2, p = NS). Compared to AV delay of 150 msec an increase in cardiac output of 0.5 L/minute was observed in three patients at an AV delay of 200 msec and in one patient at the AV delay of 250 msec. These data suggest that it is difficult to generalize an optimum AV delay in patients with dual chamber pacemakers. With the AV interval in the range of 150-250 msec, only a minority of patients could improve their haemodynamics at rest by adjusting this interval if the baseline cardiac function was normal.
J C Mohan; K K Sethi; N Pandit; M Bhargava; R Arora; M Khalilullah
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian heart journal     Volume:  44     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    1992 Mar-Apr
Date Detail:
Created Date:  1992-12-17     Completed Date:  1992-12-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  INDIA    
Other Details:
Languages:  eng     Pagination:  79-85     Citation Subset:  IM    
Department of Cardiology, G.B. Pant Hospital, New Delhi.
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MeSH Terms
Heart Block / physiopathology,  therapy*
Middle Aged
Pacemaker, Artificial*
Ventricular Function, Left / physiology

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