BENEFICIAL EFFECTS OF ATRIOVENTRICULAR SEQUENTIAL PACING ON CARDIAC OUTPUT AND LEFT VENTRICULAR FILLING ASSESSED WITH PULSED DOPPLER ECHOCARDIOGRAPHY
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概要
- 論文の詳細を見る
There has been increased interest in the beneficial effects of atrio-ventricular (AV) pacing over ventricular (V) pacing. This study attempted to evaluate the changes in cardiac output and left ventricular filling dynamics when the pacing mode was switched from V pacing to AV pacing. Study population consisted of 26 patients with multiprogrammable AV pacemakers. Cardiac output was determined as a product of echocardiographically determined cross sectional area of the aortic annulus and Doppler-determined velocity integral of left ventricular outflow over systole. Left ventricular peak rapid filling rate (PFR) and peak atrial filling velocity to peak rapid filling velocity ratio (A/R) were determined from measurements at the mitral annulus. Cardiac output showed a significant improvement when the pacing mode was switched from V to AV pacing, and the percent change ranged from 3 to 73% (average 26%). The improvement in cardiac output brought about by AV synchrony was greater in patients with smaller PFR (r = -0.71, p < 0.01) and larger A/R ratio (r= 0.77, p < 0.01). On the other hand, PFR was greater with V pacing than with AV pacing. Greater increment of the PFR was produced by the loss of atrial contraction in patients with smaller PFR (r= -0.82, p < 0.01) and larger A/R ratio (r=0.76, p < 0.01). Thus, AV pacing provides a great improvement in left ventricular filling, i. e., cardiac output, which cannot be obtained with V pacing even with the compensatory enhancement of left ventricular rapid filling. These beneficial effects of AV pacing seemed to be greater in patients with impaired left ventricular rapid filling.
- 社団法人日本循環器学会の論文
- 1986-09-20
著者
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Kitabatake Akira
The First Department Of Medicine Osaka University School Of Medicine
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Uemats Masaaki
The Cardiovascular Division Osaka Police Hospital
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Nakano Susumu
Department Of Advanced Cardiovascular Therapeutics Osaka University Graduate School Of Medicine
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Kitabatake Akira
From The Division Of Cardiology First Department Of Medicine And The Department Of Pathophysiology O
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Nanto Shinsuke
The Cardiovascular Division, Osaka Police Hospital
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Masuyama Tohru
The Cardiovascular Division, Osaka Police Hospital
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Kodama Kazuhisa
The Cardiovascular Division, Osaka Police Hospital
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Inoue Michitoshi
The First Dept. of Medicine, Osaka University
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Taniura Koichi
The Cardiovascular Division Osaka Police Hospital
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Uematsu Masaaki
The Cardiovascular Division of asaka Police Hospital
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Inoue Michitoshi
Osaka University School Of Medicine
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Inoue Michitoshi
The First Department Of Medicine Osaka University Medical School
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Kitabatake A
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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