Document Detail

Improvement of cardiac function in patients with severe congestive heart failure and coronary artery disease by dual chamber pacing with shortened AV delay.
MedLine Citation:
PMID:  7694250     Owner:  NLM     Status:  MEDLINE    
Medical therapy often fails to control symptoms of severe heart failure. The possibility of modifying to some degree the global ventricular performance with the implantation of a physiological dual chamber pacemaker, set with a short atrioventricular delay (100 msec), has been adopted in two patients with severe heart failure due to coronary artery disease. The baseline clinical condition of both patients was characterized by leg edema, ascites, dyspnea at rest, or even orthopnea with a functional New York Heart Association (NYHA) class III-IV. Acute measurements of hemodynamic and echocardiographic parameters during stepwise shortening of AV interval guided the pacemaker implantation and setting of AV delay in the chronic phase. Within a few days after pacemaker implantation, both patients considerably improved their clinical status as well as their functional NYHA class, improving to class II in one patient and to class II-III in the other patient. In addition, modification of systolic and diastolic parameters paralleled these improvements functional class and clinical condition. Pacemaker therapy in severe heart failure refractory to medical therapy can be of considerable benefit in patients whose quality-of-life is severely compromised when pharmacological therapy is no longer effective. Acute hemodynamic and echocardiographic testing is useful in assessing the most appropriate AV delay and pacing mode.
A Auricchio; L Sommariva; R W Salo; A Scafuri; L Chiariello
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  16     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-12-16     Completed Date:  1993-12-16     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:  2034-43     Citation Subset:  IM    
Department of Cardiac Surgery, Università di Roma Tor Vergata, European Hospital, Italy.
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MeSH Terms
Cardiac Pacing, Artificial / methods*
Coronary Disease / complications,  physiopathology,  therapy*
Heart Failure / complications,  physiopathology,  therapy*
Hemodynamics / physiology
Middle Aged
Pacemaker, Artificial*
Comment In:
Pacing Clin Electrophysiol. 1994 May;17(5 Pt 1):995-7   [PMID:  7517539 ]

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