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Related Experiment Videos

Atrioventricular sequential pacing: comparison with ventricular pacing using systolic time intervals.

R B Whiting, N P Madigan, F M Heinemann

    Pacing and Clinical Electrophysiology : PACE
    |March 1, 1983
    PubMed
    Summary

    Programmable pacemakers can impair heart function when switched to ventricular mode, as shown by changes in systolic time intervals. Optimizing pacemaker settings using these intervals may improve patient hemodynamics.

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    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Physiology

    Background:

    • Programmable pacemakers offer customizable settings for heart rhythm management.
    • Optimizing pacemaker function is crucial for maintaining adequate cardiac output and patient well-being.

    Purpose of the Study:

    • To investigate the impact of different pacemaker modes on cardiac function using systolic time intervals.
    • To assess the utility of systolic time intervals in selecting optimal pacemaker parameters.

    Main Methods:

    • Studied nine patients with programmable atrioventricular sequential pacemakers.
    • Measured systolic time intervals, including total electrical and mechanical systole (QS2), left ventricular ejection time (LVET), and pre-ejection period (PEP).
    • Utilized simultaneous electrocardiogram, phonocardiogram, and carotid pulse tracing recordings.

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    Main Results:

    • Switching pacemakers from atrioventricular sequential to ventricular mode significantly decreased LVET and increased PEP.
    • The PEP/LVET ratio increased from 0.428 to 0.574, indicating impaired ventricular function.
    • These changes reversed upon reprogramming to the atrioventricular sequential mode.

    Conclusions:

    • Systolic time intervals are sensitive indicators of ventricular function changes related to pacemaker mode.
    • Non-invasive assessment of systolic time intervals can guide the selection of optimal pacemaker settings (mode, rate, PR interval) for improved hemodynamics.