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Pacemaker Syndrome Evaluated by Cardiopulmonary Exercise Testing
Author(s) -
FUJIKI AKIRA,
TANI MASANAO,
MIZUMAKI KOICHI,
ASANOI HIDETSUGU,
SASAYAMA SHIGETAKE
Publication year - 1990
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.1540-8159.1990.tb02021.x
Subject(s) - medicine , cardiology , ventilation (architecture) , sick sinus syndrome , anesthesia , respiratory minute volume , perfusion , ventricular pacing , respiratory system , heart failure , mechanical engineering , engineering
Two patients who presented with dyspnea on effort, persisting after insertion of a fixed rate ventricular demand pacemaker (VVI) for sick sinus syndrome, were evaluated by cardiopulmonary exercise testing. During VVI pacing a heightened ventilatory response to exercise and a fluctuation of ventilation occurred. The high ventilatory equivalent for CO 2 throughout exercise with VVI pacing suggests that the patients had ventilation‐perfusion mismatching due to an increase in the pulmonary capillary wedge pressure caused by 1:1 ventriculoatrial conduction. Rate responsive ventricular (VVIR) pacing associated with intact 1:1 ventriculoatrial conduction exaggerated the exertional dyspnea, while rate responsive atrial (AAIR) pacing improved the ventilatory response to exercise. We suggest that a heightened ventilatory response to exercise due to ventilation‐perfusion mismatching may be an important factor causing the pacemaker syndrome, and that cardiopulmonary exercise testing is useful in identifying the exercise‐induced symptoms with ventricular pacing.