Document Detail


Cardiac output response to changes of the atrioventricular delay in different body positions and during exercise in patients receiving cardiac resynchronization therapy.
MedLine Citation:
PMID:  19578177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The aim of this study was to study the haemodynamic effect of atrioventricular delay (AVD) modifications within a narrow range in different body positions and during exercise in patients receiving cardiac resynchronization therapy (CRT). METHODS: The previously optimized AVD was shortened and prolonged by 40 ms in 27 CRT patients and 9 controls without heart failure. Cardiac output (CO) was measured by inert gas rebreathing (Innocor) as the average over different body positions (left-lateral, supine, sitting, standing, and exercise). In eight CRT patients with an implantable haemodynamic monitor, the estimated pulmonary artery diastolic pressure (ePAD) was analysed. RESULTS: The magnitude of CO response to AVD changes was greater in CRT patients than in controls (0.25 vs. 0.20 L/min, P<0.05), varied substantially between individuals (range: 0.12-0.56 L/min), and correlated with left atrial size (r=0.61, P<0.001). On average, AVD shortening decreased CO slightly (0.07+/-0.17 L/min) and increased ePAD (1.1+/-0.8 mmHg, both P<0.05), whereas prolongation had no significant effect. CONCLUSION: The haemodynamic response to AVD modifications within a narrow range is larger in CRT patients than in normal controls and varies substantially between individuals. These findings suggest that optimal AVD tuning is clinically important in selected patients.
Authors:
Marcus Ståhlberg; Morten Damgaard; Peter Norsk; Anders Gabrielsen; Anders Sahlén; Cecilia Linde; Frieder Braunschweig
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-07-04
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  11     ISSN:  1532-2092     ISO Abbreviation:  -     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-26     Completed Date:  2009-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1160-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, S-17176 Stockholm, Sweden. marcus.stahlberg@ki.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrioventricular Node / physiopathology*
Cardiac Output*
Cardiac Pacing, Artificial*
Female
Heart Failure / physiopathology*,  prevention & control*
Heart Rate*
Humans
Male
Physical Exertion*
Posture*

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


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