Document Detail


Atrial synchronized ventricular pacing: contribution of the chronotropic response to improved exercise performance.
MedLine Citation:
PMID:  6191298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In contrast to asynchronous ventricular pacing (VOO, VVI), atrial synchronized ventricular pacing (VAT, VDD, DDD) maintains the normal sequence of cardiac chamber activation and permits a chronotropic response to exercise, thereby improving exercise performance. To assess the separate contributions of these two factors to improved work capacity, 14 patients with implanted programmable VAT pacemakers were exercised according to the Bruce protocol, in three different pacing modes, selected in a random order and on a double blind basis: (a) VAT; (b) chest wall stimulation triggered ventricular (V-CWS-T) pacing, during which the pacemaker was programmed to VAT mode but driven externally using chest wall stimulation at rates fractionally above the patients' atrial rate, thereby providing a chronotropic response to exercise without atrioventricular synchronization; and (c) VOO mode at 70 beats per minute. There was a significant improvement in exercise performance in all patients during both VAT and V-CWS-T pacing as compared to VOO mode; the average increase in work capacity being similar: VAT: 44 +/- 31, (range, 12 to 140) percent and V-CWS-T; 40 +/- 24 (range, 5 to 85) percent. It is concluded that in patients with adaptive pacing systems, the chronotropic response is the major determinant of any improvement in exercise performance.
Authors:
L Fananapazir; D H Bennett; P Monks
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  6     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1983 May 
Date Detail:
Created Date:  1983-08-17     Completed Date:  1983-08-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  601-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Heart Atria / physiopathology
Heart Block / physiopathology,  therapy*
Heart Rate*
Heart Ventricles / physiopathology
Humans
Male
Middle Aged
Pacemaker, Artificial*
Physical Exertion*

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


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