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Optimum pacing mode for patients with angina pectoris
British Heart Journal
|November 1, 1986
Summary
For patients with pacemakers and angina, atrioventricular synchronous pacing (DDD) with an upper rate limit of 100 beats/min was preferred over ventricular pacing (VVI). This mode significantly reduced chest pain and dizziness.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Angina pectoris is a common symptom in patients with pacemakers.
- Optimizing pacemaker settings is crucial for symptom management and quality of life.
Purpose of the Study:
- To determine the preferred pacing mode in patients with dual chamber pacemakers and angina pectoris.
- To compare symptoms and exercise tolerance across different pacing modes.
Main Methods:
- A within-patient, double-blind, prospective study.
- 10 patients with programmable dual chamber pacemakers and angina pectoris were randomized to VVI (70 bpm), DDD (150 bpm), or DDD (100 bpm) for one month each.
- Exercise tests and symptom monitoring were conducted monthly.
Main Results:
- Atrioventricular synchronous pacing at 100 beats/min (DDD 100) was the preferred mode for 70% of patients.
- DDD 100 significantly reduced chest pain compared to VVI and DDD 150.
- Ventricular pacing (VVI) led to more dizziness, and two patients experienced pacemaker syndrome.
Conclusions:
- Atrial synchronous ventricular pacing with a limited upper rate (DDD 100) improves symptom control in patients with angina pectoris.
- This pacing strategy is superior to ventricular pacing (VVI) for managing symptoms in this patient population.