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Left ventricular function after long-term treatment with ventricular inhibited compared to atrial triggered
Acta Medica Scandinavica
|January 1, 1983
Summary
Atrial triggered ventricular (VAT) pacing offers significant hemodynamic advantages over ventricular inhibited (VVI) pacing, improving cardiac output and exercise capacity in patients with high-degree AV block.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Long-term effects of different pacemaker modes on cardiac performance are crucial for patient management.
- Ventricular inhibited (VVI) and atrial triggered ventricular (VAT) pacing are common modes for managing high-degree AV block.
Purpose of the Study:
- To compare the long-term effects of VVI and VAT pacing on cardiac performance.
- To evaluate hemodynamic differences between VVI and VAT pacing at rest and during exercise.
Main Methods:
- Cardiac catheterization was performed at rest and during exercise in 9 patients with high-degree AV block.
- Hemodynamic parameters including cardiac output, stroke volume, and pressures were measured during VVI and VAT pacing.
Main Results:
- VAT pacing significantly increased resting cardiac output (22%) and stroke volume compared to VVI pacing.
- Mean working capacity increased by 12% with VAT pacing.
- During exercise, cardiac output increased by 40% with VAT pacing due to increased heart rate.
- Stroke work and atrial rate decreased with VAT pacing, suggesting potentially lower sympathetic activity.
Conclusions:
- Hemodynamic advantages of VAT pacing are sustained even after years of VVI pacing.
- VAT pacing demonstrates superior cardiac performance compared to VVI pacing in patients with high-degree AV block.
- The findings support the continued use of VAT pacing for optimizing cardiac function.