Document Detail

Hemodynamic effect of physiological dual chamber pacing in a patient with end-stage dilated cardiomyopathy: a case report.
MedLine Citation:
PMID:  1720525     Owner:  NLM     Status:  MEDLINE    
I report a case of end-stage dilated cardiomyopathy with first-degree atrioventricular (AV) block, which had been resistant to intensive medical therapy and was eventually treated by DDD pacemaker. The optimal AV interval setting was decided using invasive right-heart catheterization and Doppler echocardiography. At a pacing rate of 92/minute, an AV interval setting of between 200 and 100 msec increased left ventricular filling and enhanced myocardial contractility. An AV interval setting of 50 msec increased the left ventricular filling further. However, this resulted in deteriorated left ventricular function. Based on these findings, the pacemaker was programmed at an optimal AV delay of 100 msec, a rate of 82-150 beats/min and a DDD mode, resulting in a good clinical course for 4 months after the therapy. Thus, it is suggested that in patients with end-stage dilated cardiomyopathy and first-degree AV block, an optimal AV delay setting using a DDD pacemaker can improve deteriorated myocardial function probably by increasing the left ventricular filling, and thus promote utility of the Frank-Starling mechanism.
H Kataoka
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  14     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1991 Sep 
Date Detail:
Created Date:  1992-01-09     Completed Date:  1992-01-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1330-5     Citation Subset:  IM    
Second Department of Internal Medicine, Medical College of Oita, Japan.
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MeSH Terms
Cardiac Pacing, Artificial / methods*
Cardiomyopathy, Dilated / complications,  physiopathology,  therapy*
Heart Block / complications,  physiopathology,  therapy*
Heart Catheterization
Hemodynamics / physiology*
Pacemaker, Artificial*

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

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