Document Detail


Role of transesophageal echocardiography in the evaluation of patients with clinical pacemaker syndrome.
MedLine Citation:
PMID:  9539479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
T M Lee; S F Su; Y J Lin; W J Chen; M F Chen; C S Liau; Y T Lee
Related Documents :
1573779 - A comparative study of a modified catheter-mediated direct current and radiofrequency a...
7090999 - Effect of isoproterenol on the anterograde refractory period of the accessory pathway i...
7148709 - Effects of verapamil on the electrophysiologic properties of the accessory pathway in p...
668079 - Clinical and electrophysiologic findings in patients with paroxysmal slowing of the sin...
10527019 - Altered cardiac histology following apical right ventricular pacing in patients with co...
6160519 - Preliminary studies with an implantable multimodal a-v pacemaker for reciprocating atri...
8614929 - Discriminative sensory dysfunction after unilateral stroke.
21172289 - Does the endoscopic appearance of the ileocecal valve suggest the severity of crohn's d...
10507509 - Schizophrenic patients and their first-degree relatives show an excess of mixed-handedn...
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    
Affiliation:
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


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...