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Left ventricular function during asynchronous ventricular pacing: a radionuclide study.

A T Weiss, M S Gotsman, B S Lewis

    Cardiology
    |January 1, 1984
    PubMed
    Summary
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    Asynchronous ventricular pacing significantly reduced left ventricular volumes and cardiac output in patients with ischemic heart disease. Optimal pacing rates vary individually, highlighting personalized pacemaker settings for heart function.

    Area of Science:

    • Cardiology
    • Cardiac Electrophysiology
    • Nuclear Cardiology

    Background:

    • Artificial pacemaker implantation is common for managing cardiac rhythm disturbances.
    • Ventricular pacing can affect cardiac hemodynamics and function.
    • Ischemic heart disease and conduction system disease present different challenges for pacing.

    Purpose of the Study:

    • To evaluate the impact of asynchronous ventricular pacing on ventricular volumes and function.
    • To compare the effects of pacing in patients with ischemic heart disease versus primary conduction disturbances.
    • To identify optimal pacing rates for maintaining cardiac output.

    Main Methods:

    • Radionuclide angiography was used to assess ventricular volumes and ejection fraction.
    • 22 patients requiring pacemakers were studied, divided into ischemic heart disease (14) and conduction disturbance (8) groups.

    Related Experiment Videos

  • Ventricular pacing was initiated and heart rate was progressively increased.

    • Main Results:

    • Asynchronous ventricular pacing significantly decreased left ventricular end-diastolic volume, stroke volume, ejection fraction, and cardiac output in patients with ischemic heart disease.
    • Patients with primary conduction disturbances showed minimal changes in ventricular function with pacing.
    • An optimal pacing rate was identified for each patient, beyond which function did not improve.

    Conclusions:

    • Asynchronous ventricular pacing adversely affects ventricular volumes and function in patients with ischemic heart disease.
    • Pacing strategies should consider the underlying cardiac condition.
    • Individualized optimization of pacing rate is crucial for maximizing cardiac output and patient outcomes.