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[Frequency-optimal pacing in chronic pacemaker therapy].

F M Grögler, H Klein, P Rathsack

    Langenbecks Archiv Fur Chirurgie
    |January 1, 1976
    PubMed
    Summary
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    Optimal pacemaker settings for patients with myocardial failure were identified, with heart rates between 90-120 bpm increasing cardiac output. Impedance cardiography reliably measured these hemodynamic changes.

    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Physiology

    Context:

    • Pacemaker implantation is a common procedure for managing bradycardia and heart failure.
    • Assessing hemodynamic response to pacing is crucial for optimizing patient outcomes.
    • Myocardial failure presents unique challenges in determining optimal pacing parameters.

    Purpose:

    • To investigate the hemodynamic effects of different pacing rates in patients with pacemakers, particularly those with myocardial failure.
    • To determine the individual optimal heart rate for pacing during rest and exercise.
    • To evaluate the correlation between impedance cardiography and thermodilution technique for hemodynamic monitoring.

    Summary:

    • Hemodynamic studies were conducted on 15 pacemaker patients using thermodilution and impedance cardiography.

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  • Optimal heart rates for pacing, ranging from 90 to 120 beats/min, were identified, especially in cases of myocardial failure.
  • A mean increase in cardiac output of 1.3 L/min was observed at optimal pacing rates compared to 70 beats/min.
  • Impedance cardiography demonstrated a high correlation with the thermodilution technique.

    • Impact:

    • Provides evidence for individualized optimal pacing rates in pacemaker patients with myocardial failure.
    • Suggests impedance cardiography as a reliable, non-invasive method for hemodynamic assessment in this population.
    • Contributes to improved management strategies and quality of life for pacemaker recipients.