The regulation of the cerebral circulation in long lasting bradycardia

In the course of long lasting bradycardia in elderly patients, cardiac output will regularly diminish, circulation will slow down and signs of cerebral insufficiency may become manifest. The changes of cerebral circulation and its regulation were studied in 10 patients 61-74 years of age, with restricted cerebral regulatory capacity, suffering from permanent bradycardia. Cerebral blood flow was measured by using the venous isotope dilution technique by double punctures of the internal jugular vein. Hemispheric cerebral blood flow, cerebral O2 consumption and cerebral vascular resistance were determined during bradycardia and after termination of bradycardia by pacemaker. During long lasting bradycardia, cerebral blood flow and cerebral O2 consumption decreased, cerebral vascular resistance was elevated. After pacemaker implantation, cerebral blood flow and O2 consumption increased and cerebral vascular resistance decreased, approaching the normal value. The symptoms of cerebral insufficiency disappeared on improvement of the cerebral circulation.