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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Related Experiment Video

Updated: May 11, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

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Published on: December 11, 2017

Ventricular rate-adaptive pacing in the elderly.

C P Lau1, C K Wong, Y T Tai

  • 1Division of Cardiology, University Department of Medicine, Queen Mary Hospital, University of Hong Kong.

European Heart Journal
|July 1, 1992
PubMed
Summary
This summary is machine-generated.

Ventricular rate-adaptive pacing (VVIR) improves exercise capacity in the elderly. Most patients preferred VVIR pacing, showing enhanced daily activity performance and improved walking distance.

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Area of Science:

  • Cardiology
  • Geriatrics
  • Biomedical Engineering

Background:

  • Elderly patients with pacemakers often experience limitations in daily activities.
  • Activity-initiated ventricular rate-adaptive pacing (VVIR) aims to optimize cardiac function based on physical demands.

Purpose of the Study:

  • To investigate the efficacy of VVIR pacing in enhancing exercise capacity and patient preference in the elderly.
  • To compare VVIR pacing with standard VVI pacing in terms of physical performance and symptomatology.

Main Methods:

  • A randomized, double-blind crossover study involving 12 elderly patients (mean age 85 years) with VVIR pacemakers.
  • Assessment included 12-min walking distance, 24-h ambulatory blood pressure monitoring, and symptom documentation comparing VVI and VVIR modes.

Main Results:

  • VVIR pacing significantly improved 12-min walking distance compared to VVI pacing (556m vs. 545m, P<0.05).
  • Pacing rates during daily activities were comparable to healthy subjects, except for strenuous tasks.
  • No significant differences in blood pressure or symptom scores were observed, but patients preferred VVIR (P<0.05).

Conclusions:

  • VVIR pacing enhances exercise capacity in the elderly population.
  • Patient preference for VVIR pacing suggests improved quality of life, even without significant symptomatic improvement.