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Hemodynamic Consequences of Atrioventricular and Ventriculoatrial Pacing
Author(s) -
OGAWA SATOSHI,
DREIFUS LEONARD S.,
SHENOY PRAKASH N.,
BROCKMAN STANLEY K.,
BERKOVITS BAROUH V.
Publication year - 1978
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1978.tb03435.x
Subject(s) - medicine , cardiology , hemodynamics , cardiac cycle , cardiac output , pulmonary artery , anesthesia , systole , blood pressure , diastole
The effect of atrialventricular versus ventricular pacing and contraction were studied in seven open‐chest dogs. Cardiac output, left ventricular, left atrial, right atrial and pulmonary artery pressures were recorded. The right or left ventricular apical areas were consistently superior as ventricular pacing sites. Appearance of cannon A waves within the pre‐ or ejection period produced a significant decrease in left ventricular and systemic blood pressure, and cardiac output with a concomitant increase in right atrial, ventricular and pulmonary pressures. Prominent “v” waves were also observed during these periods. Reducing the basic driving cycle length from 400 to 300 msec caused a marlted deterioration of all hemodynamic parameters with the appearance of mechanical alternans. Random VA conduction or ventricular pacing in the presence of com‐plete AV and VA heart block appeared to offer a more favorable hemodynamic result than constant 1:1 VA conduction. It is concluded that maintenance of a physiologic AV interval permitting atrial contraction to appear outside of pre‐ or ejection period of ventricular systole is an important determinant or ventriculor function during cardiac pacing.