Document Detail


Improved cardiovascular hemodynamics with atrioventricular sequential pacing compared with ventricular demand pacing.
MedLine Citation:
PMID:  6476948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the advantages of atrioventricular (AV) sequential pacing over ventricular demand pacing, paired cardiovascular hemodynamic studies were performed in each pacing mode at a constant heart rate. The paired studies included determination of ejection fraction (EF) by echocardiography and gated blood pool radionuclide scanning, and of cardiac output (CO) by the indicator-dilution method. There was no significant difference in EF with either pacing mode. Determined by echocardiography, EF with AV sequential pacing was 57% compared with 56% with ventricular demand pacing; by the gated blood pool method, EF with AV sequential pacing was 58% compared with 57% in the ventricular mode. Significant improvement with AV sequential pacing was seen in CO (4.75 L/min from 3.75 L/min; p less than 0.01); stroke volume (58 ml from 48 ml; p less than 0.02); arteriovenous oxygen content difference (4.9 vol% from 5.6 vol%; p less than 0.01); total peripheral resistance (1,724 dynes sec cm-5 from 2,025 dynes sec cm-5; p less than 0.01); and cardiac contractility, as reflected by mixing time (6.9 seconds from 8.0 seconds; p less than 0.02). No significant changes were noted in mean arterial or atrial pressure or in systemic oxygen consumption. In a second group of 6 patients, similar paired studies were done in AV sequential pacing modes before and after therapeutic reduction of total peripheral resistance. A significant increase in CO (43%) was observed following reduction in total peripheral resistance. We conclude that AV sequential pacing improves CO more effectively than ventricular demand pacing. Cardiac output can be further enhanced in patients with congestive heart failure by pretreatment with agents to reduce total peripheral resistance.
Authors:
S T Raza; T Z Lajos; J N Bhayana; A B Lee; A N Lewin; B Gehring; G Schimert
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  38     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1984 Sep 
Date Detail:
Created Date:  1984-10-04     Completed Date:  1984-10-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  260-4     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrioventricular Node / physiopathology*
Blood Pressure
Cardiac Output
Cardiac Pacing, Artificial / methods*
Female
Heart Conduction System / physiopathology*
Heart Failure / physiopathology,  therapy
Heart Rate
Heart Ventricles / physiopathology
Hemodynamics*
Humans
Male
Middle Aged
Myocardial Contraction
Stroke Volume
Vascular Resistance

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


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