Abstract
To determine the importance of different atrioventricular intervals during exercise in patients with dual chamber pacemakers, seven patients with complete heart block and sinus rhythm were exercised in different pacing modes and atrioventricular intervals: (a) ventricular inhibited (VVI) pacing with no synchronous atrial augmentation or rate responsiveness; (b) atrial synchronous ventricular or DDD pacing with a short mean (SD) atrioventricular interval of 66 (4) ms; and (c) DDD pacing with a long atrioventricular interval of 168 (12) ms. Pacing with a short or long atrioventricular interval gave similar maximum heart rates, oxygen uptake at the anaerobic threshold, end tidal pressure of carbon dioxide or oxygen pulse (a measure of stroke volume). Pacing with either a short or long atrioventricular interval produced a significantly higher oxygen consumption and anaerobic threshold and less lactate production than VVI pacing. During exercise a short atrioventricular interval does not provide a better cardiopulmonary performance than a long atrioventricular interval.
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Selected References
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- Ausubel K., Furman S. The pacemaker syndrome. Ann Intern Med. 1985 Sep;103(3):420–429. doi: 10.7326/0003-4819-103-3-420. [DOI] [PubMed] [Google Scholar]
- Benchimol A., Ellis J. G., Dimond E. G. Hemodynamic consequences of atrial and ventricular pacing in patients with normal and abnormal hearts. Effect of exercise at a fixed atrial and ventricular rate. Am J Med. 1965 Dec;39(6):911–922. doi: 10.1016/0002-9343(65)90113-0. [DOI] [PubMed] [Google Scholar]
- Benditt D. G., Mianulli M., Fetter J., Benson D. W., Jr, Dunnigan A., Molina E., Gornick C. C., Almquist A. Single-chamber cardiac pacing with activity-initiated chronotropic response: evaluation by cardiopulmonary exercise testing. Circulation. 1987 Jan;75(1):184–191. doi: 10.1161/01.cir.75.1.184. [DOI] [PubMed] [Google Scholar]
- Carleton R. A., Passovoy M., Graettinger J. S. The importance of the contribution and timing of left atrial systole. Clin Sci. 1966 Feb;30(1):151–159. [PubMed] [Google Scholar]
- Faerestrand S., Ohm O. J. A time-related study of the hemodynamic benefit of atrioventricular synchronous pacing evaluated by Doppler echocardiography. Pacing Clin Electrophysiol. 1985 Nov;8(6):838–848. doi: 10.1111/j.1540-8159.1985.tb05903.x. [DOI] [PubMed] [Google Scholar]
- Fananapazir L., Srinivas V., Bennett D. H. Comparison of resting hemodynamic indices and exercise performance during atrial synchronized and asynchronous ventricular pacing. Pacing Clin Electrophysiol. 1983 Mar;6(2 Pt 1):202–209. doi: 10.1111/j.1540-8159.1983.tb04347.x. [DOI] [PubMed] [Google Scholar]
- Hartzler G. O., Maloney J. D., Curtis J. J., Barnhorst D. A. Hemodynamic benefits of atrioventricular sequential pacing after cardiac surgery. Am J Cardiol. 1977 Aug;40(2):232–236. doi: 10.1016/0002-9149(77)90013-3. [DOI] [PubMed] [Google Scholar]
- Haskell R. J., French W. J. Optimum AV interval in dual chamber pacemakers. Pacing Clin Electrophysiol. 1986 Sep;9(5):670–675. doi: 10.1111/j.1540-8159.1986.tb05414.x. [DOI] [PubMed] [Google Scholar]
- Humen D. P., Kostuk W. J., Klein G. J. Activity-sensing, rate-responsive pacing: improvement in myocardial performance with exercise. Pacing Clin Electrophysiol. 1985 Jan;8(1):52–59. doi: 10.1111/j.1540-8159.1985.tb05723.x. [DOI] [PubMed] [Google Scholar]
- Karlöf I. Haemodynamic effect of atrail triggered versus fixed rate pacing at rest and during exercise in complete heart block. Acta Med Scand. 1975 Mar;197(3):195–206. [PubMed] [Google Scholar]
- Kruse I., Rydén L. Comparison of physical work capacity and systolic time intervals with ventricular inhibited and atrial synchronous ventricular inhibited pacing. Br Heart J. 1981 Aug;46(2):129–136. doi: 10.1136/hrt.46.2.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perrins E. J., Morley C. A., Chan S. L., Sutton R. Randomised controlled trial of physiological and ventricular pacing. Br Heart J. 1983 Aug;50(2):112–117. doi: 10.1136/hrt.50.2.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rahimtoola S. H., Ehsani A., Sinno M. Z., Loeb H. S., Rosen K. M., Gunnar R. M. Left atrial transport function in myocardial infarction. Importance of its booster pump function. Am J Med. 1975 Nov;59(5):686–694. doi: 10.1016/0002-9343(75)90229-6. [DOI] [PubMed] [Google Scholar]
- Reiter M. J., Hindman M. C. Hemodynamic effects of acute atrioventricular sequential pacing in patients with left ventricular dysfunction. Am J Cardiol. 1982 Mar;49(4):687–692. doi: 10.1016/0002-9149(82)91947-6. [DOI] [PubMed] [Google Scholar]
- Samet P., Castillo C., Bernstein W. H. Hemodynamic sequelae of atrial, ventricular, and sequential atrioventricular pacing in cardiac patients. Am Heart J. 1966 Dec;72(6):725–729. doi: 10.1016/0002-8703(66)90154-2. [DOI] [PubMed] [Google Scholar]
- Shapland J. E., MacCarter D., Tockman B., Knudson M. Physiologic benefits of rate responsiveness. Pacing Clin Electrophysiol. 1983 Mar;6(2 Pt 2):329–332. doi: 10.1111/j.1540-8159.1983.tb04369.x. [DOI] [PubMed] [Google Scholar]
- Sutton R., Morley C., Chan S. L., Perrins J. Physiological benefits of atrial synchrony in paced patients. Pacing Clin Electrophysiol. 1983 Mar;6(2 Pt 2):327–328. doi: 10.1111/j.1540-8159.1983.tb04368.x. [DOI] [PubMed] [Google Scholar]
- von Bibra H., Wirtzfeld A., Hall R., Ulm K., Blömer H. Mitral valve closure and left ventricular filling time in patients with VDD pacemakers. Assessment of the onset of left ventricular systole and the end of diastole. Br Heart J. 1986 Apr;55(4):355–363. doi: 10.1136/hrt.55.4.355. [DOI] [PMC free article] [PubMed] [Google Scholar]
