Document Detail


Incidence and significance of chronotropic incompetence in patients with indications for primary pacemaker implantation or pacemaker replacement.
MedLine Citation:
PMID:  10527009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This prospective study was undertaken to evaluate the incidence and significance of chronotropic incompetence in 211 patients [age 71.1 6 10.6 years (mean 6 SD)] by means of maximum exercise test in order to determine the indication for rate-responsive pacing before primary pacemaker implantation (147 patients) or pacemaker replacement (64 patients). There were 112 (53%) patients with second- or third-degree AV block, 63 (30%) with sick sinus syndrome, and 36 (17%) with chronic atrial fibrillation. Chronotropic incompetence was defined as maximum heart rate lower than age-adjusted norm calculated by the formula: 0.7x(220 - age) and its significance as the difference between the two rates. The overall incidence of chronotropic incompetence was 42%. The incidence was significantly higher in patients with atrial fibrillation (67%, P<0.0005) and sick sinus syndrome (49%, P<0.012) than in those with AV block (30%). The mean difference between maximum heart rate and the age-adjusted norm was 18% (range 2%-63%). The mean difference was significantly higher in patients with atrial fibrillation (27%, range 8-63%) than in those with sick sinus syndrome (19%, range 2%-45%, P<0.01), or with AV block (12%, range 6%-26%, P<0.000001). The rate-responsive pacemakers were implanted in 44% of 211 patients studied and in 43% of 196 patients excluded from the study due to the apparent (contra)indication of rate-responsive pacing (NS). Thus, chronotropic incompetence seems to be common in the pacemaker patient population. The highest incidence and significance was found in patients with chronic atrial fibrillation. Systematic evaluation of chronotropic competence can double the rate of implantation of rate-responsive pacemakers; however, further studies are needed to clarify relation between the significance of chronotropic incompetence and functional benefit of rate-responsive pacing.
Authors:
J Lukl; V Doupal; E Sovová; L Lubena
Related Documents :
7153239 - High patency rate of internal arteriovenous fistulae in non-uremic patients with normal...
4076199 - Effects of intravenous diltiazem administration in patients with inducible tachycardia.
24561659 - Advantages of respiratory monitoring during video-eeg evaluation to differentiate epile...
24251039 - Fatigue and sleep-disordered breathing in multiple sclerosis: a clinically relevant ass...
3578049 - Concordance of distinguishing electrocardiographic features during sinus rhythm with th...
23756679 - Balance deficit with opened or closed eyes reveals involvement of different structures ...
22975639 - Alu-based cell-free dna: a potential complementary biomarker for diagnosis of colorecta...
10655359 - Serology of culture-confirmed cases of human granulocytic ehrlichiosis.
25187589 - Primary epiphyseal osteomyelitis caused by mycobacterium species in otherwise healthy t...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  22     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-11-15     Completed Date:  1999-11-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1284-91     Citation Subset:  IM    
Affiliation:
1st Medical Department, University Hospital, Olomouc, Czech Republic.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / physiopathology,  therapy
Exercise Test
Female
Heart Block / physiopathology,  therapy
Heart Rate
Humans
Male
Pacemaker, Artificial*
Prospective Studies
Sick Sinus Syndrome / physiopathology,  therapy

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


Previous Document:  The effects of lottery incentive and length of questionnaire on health survey response rates: a rand...
Next Document:  Value of magnetocardiographic QRST integral maps in the identification of patients at risk of ventri...