[Hemodynamic and exercise capacity in a 72 years old patient under a ventricular and bifocal pacemaker (author's...

The results of haemodynamic, echocardiographic and bicycle exercise investigations in a 72-year-old man with a permanent complete atrioventricular block and heart failure following infarction are presented. Comparative measurements were obtained under the conditions of a ventricular and an av-sequential pacemaker (PM). The ventricular demand pacemaker (VVI) was implanted three years ago and because of further impairment of cardiac performance an av-sequential pacemaker (DDD) was used to restore atrio-ventricular synchronisation. The treatment with bifocal PM improved dramatically cardiac output and exercise capacity. The echocardiographic findings demonstrate the significance of Frank-Starling mechanism in this case due to better filling of the ventricles. As noninvasive methods, echocardiography and bicycle-exercise test allow long-term analysis of cardiac function.