Document Detail

Comparison of the effects of VVI versus DDD pacing on cardiac baroreflex function.
MedLine Citation:
PMID:  16684027     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Conventional baroreceptor-heart rate (HR) reflex sensitivity cannot be examined in chronotropically incompetent patients or in pacemaker recipients. However, cardiac baroreceptor reflex sensitivity (BRS)-stroke volume (SV), which is closely and linearly correlated with BRS-HR, may be an alternative in that population. The aim of this study was to compare the BRS-SV in pacemaker recipients with a fixed HR paced in VVI versus DDD modes in the supine and upright positions. METHODS: The pacing mode was set randomly to DDD or VVI with complete atrial and/or ventricular capture, then crossed over to the alternate mode in 9 recipients of dual-chamber pacemakers with atrioventricular (AV) block. Beat-to-beat mean blood pressure and SV were measured in the supine and upright positions, using a tilt table. The BRS-SV, expressed in %/mmHg, was the ratio of low-frequency (LF) power to total power (TP) of SV variability, measured by spectral analysis of spontaneous variations in mean blood pressure and SV. RESULTS: BRS-SV was significantly lower in the VVI than in the DDD mode in the supine (37.2 +/- 26.7 vs 14.5 +/- 7.7%/mmHg) and upright (22.9 +/- 16.9 vs 10.6 +/- 6.6%/mmHg) positions (P < 0.05 for both comparisons). CONCLUSIONS: VVI pacing is adverse from the standpoint of cardiac autonomic baroreflex function. A decreased BRS-SV may be one of the factors involved in the hemodynamic intolerance associated with VVI pacing.
Yasushi Oginosawa; Haruhiko Abe; Tomiya Yasumasu; Takuo Tsurugi; Ritsuko Kohno
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  17     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-10     Completed Date:  2006-10-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  526-31     Citation Subset:  IM    
Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / physiopathology*,  prevention & control*
Blood Pressure*
Cardiac Pacing, Artificial / methods*
Heart Conduction System / physiopathology*
Middle Aged
Stroke Volume*
Comment In:
J Cardiovasc Electrophysiol. 2006 May;17(5):532-3   [PMID:  16684028 ]

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

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