Document Detail

Role of transesophageal echocardiography in the evaluation of patients with clinical pacemaker syndrome.
MedLine Citation:
PMID:  9539479     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The goal of this study was to investigate the possible role of transesophageal echocardiography in the evaluation of patients with clinical pacemaker syndrome. BACKGROUND: Several reports on transthoracic echocardiographic features of ventricular pacing were described; however, no previous study of transesophageal echocardiography has been undertaken in patients at the severe end of pacemaker syndrome who need reprogramming of dual-chamber pacing for symptom relief. METHODS: Twelve patients with ventricular-inhibited pacemakers (VVI) with clinical symptomatic pacemaker syndrome (group I) and 10 patients with VVI without pacemaker syndrome (group II) were prospectively studied. The two groups were pacemaker dependent and had persistent ventriculoatrial conduction. Transesophageal echocardiographic parameters were assessed in group II and within 6 hours before reprogramming to the DDD mode in group I. Follow-up transesophageal echocardiographic study was performed 28+/-5 days after reprogramming in group I. RESULTS: All patients in group I had subjective improvements of symptoms after DDD reprogramming. The atrial reverse flow velocities of pulmonary veins in group I before reprogramming were significantly higher in group II (39.3+/-11.4 versus 15.7+/-13.5 cm/sec, p < 0.0001). Spontaneous echo contrast in the descending aorta was detected in all patients from group I before reprogramming. The prevalence of significant mitral regurgitation (> or = moderate) was significantly higher in group I before reprogramming than in group II (67% versus 8%, p = 0.01). Significant mitral regurgitation and spontaneous echo contrast in the descending aorta in group I disappeared after reprogramming to the DDD mode. CONCLUSIONS: Transesophageal echocardiography provides physiologic, pacemaker-related hemodynamic changes in paced patients. Significantly higher atrial reverse flow velocities of pulmonary veins, increased frequency of spontaneous echo contrast in the descending aorta, and significant mitral regurgitation are peculiar echocardiographic findings in patients with VVI with clinical pacemaker syndrome.
T M Lee; S F Su; Y J Lin; W J Chen; M F Chen; C S Liau; Y T Lee
Related Documents :
9665059 - Noninvasive diagnosis of dual av node physiology in patients with av nodal reentrant ta...
19889189 - Autonomic function during closed loop stimulation and fixed rate pacing: heart rate var...
18299309 - A novel pacing manoeuvre to diagnose atrial tachycardia.
9062019 - In-hospital results of radiofrequency ablation of supraventricular tachycardia.
23731219 - Toll-like receptor-9 in spanish multiple sclerosis patients: an association with the ge...
7153239 - High patency rate of internal arteriovenous fistulae in non-uremic patients with normal...
15249509 - Association of atrial fibrillation and obstructive sleep apnea.
6739049 - Low-vision aids for patients with suboptimal vision after closed vitrectomy for diabeti...
23574939 - Oxidative stress in complex regional pain syndrome (crps): no systemically elevated lev...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  135     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-04-24     Completed Date:  1998-04-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  634-40     Citation Subset:  AIM; IM    
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aorta, Thoracic / ultrasonography
Atrial Function, Left
Blood Flow Velocity
Echocardiography, Doppler
Echocardiography, Transesophageal*
Follow-Up Studies
Heart Atria / physiopathology,  ultrasonography
Heart Conduction System
Heart Diseases / etiology,  physiopathology,  ultrasonography*
Middle Aged
Pacemaker, Artificial / adverse effects*
Prospective Studies
Pulmonary Veins / ultrasonography

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

Previous Document:  Mechanism of luminal narrowing in cardiac allograft vasculopathy: inadequate vascular remodeling rat...
Next Document:  Mitral inflow and pulmonary venous Doppler measurements do not predict pulmonary capillary wedge pre...