Document Detail


Rate-adaptive pacing using intracardiac impedance shows no evidence for positive feedback during dobutamine stress test.
MedLine Citation:
PMID:  12134978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Inos2 DDDR pacemaker senses unipolar intracardiac impedance signals for adapting heart rate to meet the haemodynamic needs of physical activity. Theoretically, such pacing devices could be limited by positive feedback since increase in beating frequency per se enhances contractility. We have addressed this problem in patients with chronotropic incompetence who were subjected to a pharmacological stress test. METHODS AND RESULTS: Twelve patients with chronically implanted Inos2 DDDR pacemakers were studied using the standard protocol of stress echocardiography. Most of the patients reached the programmable maximum closed-loop rate during the incremental dobutamine challenge. The time courses for increase in as well as for recovery of heart rate were not different from control patients receiving routine diagnostic stress echocardiography. CONCLUSIONS: In patients implanted with the Inos2 DDDR pacemaker acute stimulation with intravenous dobutamine leads to a robust increase in paced heart rate without any evidence of positive feedback.
Authors:
Torsten Christ; Matthias Schier; Arne Brattström; Gerhardt Muth; Andreas Hartmann; Dobromir Dobrev; Ursula Ravens
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  4     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-23     Completed Date:  2003-01-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  311-5     Citation Subset:  IM    
Affiliation:
Department of Pharmacology and Toxicology, Medical Faculty, University of Technology, Dresden, Germany. Christ@rcs.urz.tu-dresden.de
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MeSH Terms
Descriptor/Qualifier:
Cardiac Pacing, Artificial*
Cardiotonic Agents / pharmacology
Dobutamine / pharmacology
Echocardiography, Stress
Feedback*
Female
Heart Rate* / drug effects,  physiology
Humans
Male
Middle Aged
Monitoring, Physiologic
Myocardial Contraction
Pacemaker, Artificial
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

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


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