| Do we need a reflex tachycardia to stand up? | |
| | |
MedLine Citation:
|
PMID: 16176536 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Sophisticated atrio-ventricular pacing models are designed to integrate the pacemaker into cardiovascular autonomic control to react appropriately to the cardiovascular demands. Such an approach might be beneficial for patients with vasovagal responses to counterbalance the upright fall in arterial blood pressure by a pacing rate increase. We hypothesized that this approach would improve the cardiovascular response to standing in comparison with a regular pacing mode. METHODS: Two 5-minute tilt tests were performed in a random order in 5 patients with a pacemaker (CLS-INOS(2)) for sinus node disease and atrio-ventricular block. One tilt test was performed in fixed pacing rate (DDD), the other one was performed in close loop stimulation (CLS), which allowed an upright rate-rise pacing. Heart rate, systolic blood pressure, and cardiac output (modelflow) were recorded on a beat-by-beat basis. RESULTS: Changes of systolic blood pressure and cardiac output in response to upright posture were not significantly different between DDD and CLS modes (2.7 +/- 13.2 vs 10.1 +/- 12.9 mmHg and -0.8 +/- 0.3 vs -1.1 +/- 0.4 L/min, respectively). But upright posture led to a tachycardia of more than 30 bpm in 3 patients in CLS mode and to a fall in systolic blood pressure greater than 20 mmHg in 3 patients in CLS mode and only in one patient in DDD mode. CONCLUSION: Systolic blood pressure and cardiac output are not improved by the upright tachycardia and upright blood pressure response is actually worsened when an upright rate-rise pacing is used. Thus, it appears that tachycardia alone cannot compensate for an upright fall in blood pressure. |
| | |
Authors:
|
Jacques-Olivier Fortrat; Catherine Lemarie; Elisabeth Bellard; Jacques Victor |
Related Documents
:
|
11669106 - System identification of dynamic closed-loop control of total peripheral resistance by ... 2621436 - Abnormal cardiovascular responses to postural changes and pharmacologic agents in a cas... 11902176 - Fluid volumes changes induced by spaceflight. 8553876 - Central blood volume influences sympathetic sudomotor nerve traffic in warm humans. 11875306 - Isolated diastolic hypertension, pulse pressure, and mean arterial pressure as predicto... 1774826 - Cardiovascular response to mental stress and to handgrip in children. the role of physi... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Pacing and clinical electrophysiology : PACE Volume: 28 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2005 Sep |
Date Detail:
|
Created Date: 2005-09-22 Completed Date: 2006-01-03 Revised Date: 2009-11-03 |
Medline Journal Info:
|
Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
|
Languages: eng Pagination: 962-7 Citation Subset: IM |
Affiliation:
|
Laboratoire de Physiologie, Faculté de Médecine, Centre Hospitalo-Universitaire, Faculté de Médecine, 49045 Angers Cedex, France. jofortrat@chu-angers.fr |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Blood Pressure / physiology Cardiac Output / physiology Female Heart Block / physiopathology, therapy* Heart Rate / physiology Humans Male Middle Aged Pacemaker, Artificial* Posture* Sick Sinus Syndrome / physiopathology, therapy* Statistics, Nonparametric Syncope, Vasovagal / physiopathology* Tachycardia / physiopathology* Tilt-Table Test |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Efficacy and safety of ibutilide for cardioversion of atrial flutter and fibrillation in patients re...
Next Document: Tilt testing: is it necessary in all patients with suspected vaso-vagal syncope?