PMID- 10666756
OWN - NLM
STAT- MEDLINE
DCOM- 20000218
LR  - 20190726
IS  - 0147-8389 (Print)
IS  - 0147-8389 (Linking)
VI  - 23
IP  - 1
DP  - 2000 Jan
TI  - Preserving normal ventricular activation versus atrioventricular delay 
      optimization during pacing: the role of intrinsic atrioventricular conduction and 
      pacing rate.
PG  - 74-83
AB  - The purpose of the study was to compare the effects of DDD pacing with optimal AV 
      delay and AAI pacing on the systolic and diastolic performance at rest in 
      patients with prolonged intrinsic AV conduction (first-degree AV block). We 
      studied 17 patients (8 men, aged 69 +/- 9 years) with dual chamber pacemakers 
      implanted for sick sinus syndrome in 15 patients and paroxysmal high degree AV 
      block in 2 patients. Aortic flow and mitral flow were evaluated using Doppler 
      echocardiography. Study protocol included the determination of the optimal AV 
      delay in the DDD mode and comparison between AAI and DDD with optimal AV delay 
      for pacing rate 70/min and 90/min. Stimulus-R interval during AAI (ARI) was 282 
      +/- 68 ms for rate 70/min and 330 +/- 98 ms for rate 90/min (P < 0.01). The 
      optimal AV delay was 159 +/- 22 ms. AV delay optimization resulted in an increase 
      of an aortic flow time velocity integral (AFTVI) of 16% +/- 9%. At rate 70/min 
      the patients with ARI < or = 270 ms had higher AFTVI in AAI than in DDD (0.214 
      +/- 0.05 m vs 0.196 +/- 0.05 m, P < 0.01), while the patients with ARI > 270 ms 
      demonstrated greater AFTVI under DDD compared to AAI (0.192 +/- 0.03 m vs 0.166 
      +/- 0.02 m, P < 0.01). At rate 90/min AFTVI was higher during DDD than AAI (0.183 
      +/- 0.03 m vs 0.162 +/- 0.03 m, P < 0.01). Mitral flow time velocity integral 
      (MFTVI) at rate 70/min was higher in DDD than in AAI (0.189 +/- 0.05 m vs 0.173 
      +/- 0.05 m, P < 0.01), while at rate 90/min the difference was not significant in 
      favor of DDD (0.149 +/- 0.05 m vs 0.158 +/- 0.04 m). The results suggest that in 
      patients with first-degree AV block the relative impact of DDD and AAI pacing 
      modes on the systolic performance depends on the intrinsic AV conduction time and 
      on pacing rate.
FAU - Iliev, I I
AU  - Iliev II
AD  - Third Department of Internal Medicine, Nagasaki University, Japan. 
      d396027h@stcc.nagasaki-u.ac.jp
FAU - Yamachika, S
AU  - Yamachika S
FAU - Muta, K
AU  - Muta K
FAU - Hayano, M
AU  - Hayano M
FAU - Ishimatsu, T
AU  - Ishimatsu T
FAU - Nakao, K
AU  - Nakao K
FAU - Komiya, N
AU  - Komiya N
FAU - Hirata, T
AU  - Hirata T
FAU - Ueyama, C
AU  - Ueyama C
FAU - Yano, K
AU  - Yano K
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrioventricular Node/*physiopathology
MH  - Blood Flow Velocity
MH  - *Cardiac Pacing, Artificial
MH  - Echocardiography, Doppler
MH  - Female
MH  - Heart Block/diagnostic imaging/*physiopathology/therapy
MH  - Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - Treatment Outcome
EDAT- 2000/02/10 09:00
MHDA- 2000/02/26 09:00
CRDT- 2000/02/10 09:00
PHST- 2000/02/10 09:00 [pubmed]
PHST- 2000/02/26 09:00 [medline]
PHST- 2000/02/10 09:00 [entrez]
AID - 10.1111/j.1540-8159.2000.tb00652.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2000 Jan;23(1):74-83. doi: 
      10.1111/j.1540-8159.2000.tb00652.x.