| Role of transesophageal echocardiography in the evaluation of patients with clinical pacemaker syndrome. | |
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MedLine Citation:
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PMID: 9539479 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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T M Lee; S F Su; Y J Lin; W J Chen; M F Chen; C S Liau; Y T Lee |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: American heart journal Volume: 135 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1998 Apr |
Date Detail:
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Created Date: 1998-04-24 Completed Date: 1998-04-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 634-40 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aorta, Thoracic / ultrasonography Atrial Function, Left Blood Flow Velocity Echocardiography, Doppler Echocardiography, Transesophageal* Electrocardiography Female Follow-Up Studies Heart Atria / physiopathology, ultrasonography Heart Conduction System Heart Diseases / etiology, physiopathology, ultrasonography* Humans Male Middle Aged Pacemaker, Artificial / adverse effects* Prospective Studies Pulmonary Veins / ultrasonography Syndrome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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