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Noninvasive Assessment by Doppler and M‐Mode Echocardiography of Hemodynamic Responses to Temporary Pacing and to Ventriculoatrial Conduction
Author(s) -
FAERESTRAND SVEIN,
ØIE BERTIL,
OHM OLEJØRGEN
Publication year - 1987
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.1540-8159.1987.tb06044.x
Subject(s) - medicine , cardiology , stroke volume , doppler echocardiography , hemodynamics , ventricular pacing , cardiac pacing , heart rate , anesthesia , heart failure , blood pressure , diastole
A new, dual‐chamber temporary pacing lead was introduced via the subclavian vein in 20 patients who needed a temporary pacemaker. Stroke volume (SV) was measured continuously by combining M‐mode and noninvasive Doppier echocardiography during spontaneous rhythm (SR), AV sequential pacing at a positive AV interval (DP), ventricular pacing (VP) and AV sequential pacing at a negative AV interval (VA pacing). The valvular functions were determined by Doppler echocardiography. Left ventricular dimensions and function, and left atrial size were measured by M‐mode echocardiography. In the nine patients with no valvular heart disease and with no ventriculoatrial (VA) conduction (group I) the CO increased 83 ±11% during DP and 42 ± 9% during VP as compared to during SR when the heart rate (HE) was increased from 34 ± 3 to 72 ± 1 beats/min. The CO was 29 ± 3% higher during DP than that during VP. In the seven patients with valvulox heart disease and with no VA conduction (group II), the increment in CO compared to that during Sfi was SZ ± 12% during DP and 31 ±17% during VP: the CO was 17 ± 4% higher during DP than that during VP. In the four patients with spontaneous VA conduction (group III), the CO during DP was 35 ± 10% greater than that during VP, which did not result in an increase in the CO compared to that during SR in spile of an increase in HR from 52 ± 8 to 74 ± 2 beats/min. The study demonstrated that DP is the preferred temporary pacing mode and also that VA conduction during VP resulted in a mean decrease of 20% in CO compared to that during VP without VA conduction. The hemodynamic benefit from DP compared to SR seems to decrease when the left ventricular end‐diastolic dimension increases. Furthermore, patients with large left ventricular end‐systolic dimensions seem to have a lower increase in stroke index during DP as compared to that during VP than patients with smaller end‐systolic dimensions.