Changes in Evoked QT Intervals According to Variations in Atrioventricular Delay and Cardiac Function in Patients With Implanted QT-Driven DDDR Pacemakers

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概要

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• In patients with implanted DDD pacemaker, cardiac output is maximal when atrioventricular (AV) delay is set to give the maximum QT interval (QTI). QTI is used as a sensor of a rate-responsive pacemaker and the evoked QTI (eQTI) is measured as the time duration from the ventricular pace-pulse and the T sense point, which is the steepest point of the intracardiac T wave. The relationship between the changes in eQTI according to AV delay variations and cardiac function was studied in 13 patients (74.2±9.3 [SD] years old) with an implanted QT-driven DDDR-pacemaker. A special software module was downloaded into the pacemaker memory and a personal computer equipped with the special software was connected to the programmer for eQTI date-logging. AV delay was set at 100, 120, 150, 180 and 210ms. Delta eQTI was defined as maximal eQTI-minimal eQTI. The ejection fraction (EF) was measured by echocardiography. When the AV delay was prolonged, eQTI gradually increased and reached a peak, and then decreased. Delta eQTI in patients with reduced cardiac function (EF<40%) was significantly greater than that in normal cardiac function (EF>55%, 7.6±4.9 vs 2.7±9,8ms, p<0.05). There was significant negative correlation between EF and delta eQTI (r=-0.63, p<0.05). The peak of changes in eQTI according to AV delay variations was steeper in patients with reduced cardiac function than in those with normal cardiac function. In conclusion, changes in eQTI according to AV delay variation are greater in patients with reduced cardiac function than in those with normal cardiac function, and the AV delay that gives the maximal eQTI can be easily determined in patients with reduced cardiac function. (Circ J 2003; 67: 515-518)

• 社団法人日本循環器学会の論文
• 2003-05-20

著者

• Ishikawa Toshiyuki

  Second Department of Internal Medicine, Yokohama City University Hospital

• Sumita Shinichi

  Second Department of Internal Medicine, Yokohama City University Hospital

• Kosuge Masami

  Second Department of Internal Medicine, Yokohama City University Hospital

• Uchino Kazuaki

  Second Department of Internal Medicine, Yokohama City University Hospital

• Kobayashi Tsukasa

  Second Department of Internal Medicine, Yokohama City University Hospital

• Kimura Kazuo

  Second Department of Internal Medicine, Yokohama City University Hospital

• Umemura Satoshi

  Second Department of Internal Medicine, Yokohama City University Hospital

• Uchino Kazuaki

  横浜市立大学附属市民総合医療センター 心臓血管センター

• Kosuge Masami

  Yokohama City University School Of Medicine Cardiovascular Center

• Yamakawa Y

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University School Of Medicine

• Yamakawa Yohei

  横浜市立大学 第二内科学教室

• Yamakawa Yohei

  Second Department Of Internal Medicine Yokohama City University School Of Medicine

• Sumita Shinichi

  Second Department Of Internal Medicine Yokohama City University Hospital

• Kobayashi Tsukasa

  横浜市立大学 医学研究科内科学循環器内科

• Kobayashi Tsukasa

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University Graduate School Of M

• Usui Takashi

  Department of Cardiology, Fujisawa Municipal Hospital

• Usui Takashi

  Department Of Cardiology Fujisawa Municipal Hospital

• Kobayashi I

  Department Of Cardiology Sagamihara Hospital

• Minami Kazutoshi

  Yokohama City University Medical Center

• Kohagura Kentaro

  琉球大学 第三内科

• Yamakawa Youhei

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University School Of Medicine

• Matsumoto Katsumi

  Second Department of Internal Medicine, Yokohama City University School of Medicine

• Sugano Teruyasu

  Second Department of internal medicine, Yokohama City University School of Medicine

• Ohkusu Yasuo

  Second Department of Internal Medicine, Yokohama City University Hospital

• Matsusita Kohei

  Second Department of Internal Medicine, Yokohama City University School of Medicine

• Kobayashi Izumi

  Second Department of Internal Medicine, Yokohama City University School of Medicine

• Usui Takashi

  Second Department of Internal Medicine, Yokohama City University School of Medicine

• Umemura Satoshi

  Second Department Of Internal Medicine Yokohama City University School Of Medicine

• Okusu Yasuo

  Second Department Of Internal Medicine Yokohama City University Hospital

• Ishikawa Toshiyuki

  Second Department Of Internal Medicine Yokohama City University Hospital

• Minamizawa Kousuke

  Second Department Of Internal Medicine Yokohama City University School Of Medicine

• Kobayashi Izumi

  Department Of Cardiology National Sagamihara Hospital

• Kimura Kazuo

  Second Department Of Internal Medicine Yokohama City University School Of Medicine

• Kobayashi Izumi

  Second Department Of Internal Medicine Yokohama City University School Of Medicine

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