Document Detail

Impact of right ventricular pacing sites on exercise capacity during ventricular rate regularization in patients with permanent atrial fibrillation.
MedLine Citation:
PMID:  19825009     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The deleterious effects of right ventricular apical (RVA) pacing may offset the potential benefit of ventricular rate (VR) regularization and rate adaptation during an exercise in patient's atrial fibrillation (AF). METHODS: We studied 30 patients with permanent AF and symptomatic bradycardia who receive pacemaker implantation with RVA (n = 15) or right ventricular septal (RVS, n = 15) pacing. All the patients underwent an acute cardiopulmonary exercise testing using VVI-mode (VVI-OFF) and VVI-mode with VR regularization (VRR) algorithm on (VVI-ON). RESULTS: There were no significant differences in the baseline characteristics between the two groups, except pacing QRS duration was significantly shorter during RVS pacing than RVA pacing (138.9 +/- 5 vs 158.4 +/- 6.1 ms, P = 0.035). Overall, VVI-ON mode increased the peak exercise VR, exercise time, metabolic equivalents (METs), and peak oxygen consumption (VO(2)max), and decreased the VR variability compared with VVI-OFF mode during exercise (P < 0.05), suggesting that VRR pacing improved exercise capacity during exercise. However, further analysis on the impact of VRR pacing with different pacing sites revealed that only patients with RVS pacing but not patients with RVA pacing had significant increased exercise time, METs, and VO(2)max during VVI-ON compared with VVI-OFF, despite similar changes in peaked exercise VR and VR variability. CONCLUSION: In patients with permanent AF, VRR pacing at RVS, but not at RVA, improved exercise capacity during exercise.
Hung-Fat Tse; Chung-Wah Siu; Chu-Pak Lau
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Publication Detail:
Type:  Journal Article     Date:  2009-10-13
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  32     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1536-42     Citation Subset:  IM    
Department of Medicine, Cardiology Division, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China..
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / therapy*
Bradycardia / therapy
Cardiac Pacing, Artificial / methods*
Exercise Test
Exercise Tolerance / physiology*
Heart Ventricles*
Middle Aged
Oxygen Consumption

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

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