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Physiologic pacing in the elderly. Effects on exercise capacity and exercise-induced arrhythmias
L Jordaens1, G de Backer, D L Clement
1Department of Cardiology, Akademisch Ziekenhuis, State University Ghent, Belgium.
Japanese Heart Journal
|January 1, 1988
Summary
Dual-chamber pacing (DDD) improves exercise capacity in elderly patients with complete heart block. This physiologic stimulation enhances quality of life without significant arrhythmias.
Area of Science:
- Cardiology
- Geriatrics
- Biomedical Engineering
Background:
- Dual-chamber pacing (DDD) offers hemodynamic benefits, but its efficacy in elderly patients with complete heart block is not well-established.
- Elderly individuals with pacemakers often have comorbidities that may affect pacing outcomes.
Purpose of the Study:
- To compare the effects of DDD versus single-chamber ventricular pacing (VVI) on exercise capacity and atrial rate in elderly patients.
- To evaluate exercise-induced arrhythmias and overall outcomes in this patient group.
Main Methods:
- A randomized study involving 18 elderly patients (mean age 74) with complete heart block.
- Exercise testing was performed in both DDD and VVI pacing modes.
- Key parameters assessed included exercise capacity, atrial rate, and arrhythmias.
Main Results:
- DDD pacing significantly reduced atrial rate during exercise (p<0.01) and improved exercise time, cumulative load, and maximal oxygen uptake (p<0.05).
- No significant differences were observed in exercise-induced arrhythmias between pacing modes.
- Reprogramming was seldom required, and sinus rhythm was maintained in all patients at follow-up.
Conclusions:
- Physiologic dual-chamber pacing (DDD) is beneficial for active elderly patients with complete heart block.
- DDD pacing enhances exercise capacity and quality of life in this population.
- Single-chamber pacing (VVI) may be less effective in optimizing outcomes for these patients.