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PR Interval Behavior During Exercise: Implications for Physiological Pacemakers
Author(s) -
LUCERI RICHARD M.,
BROWNSTEIN SHELDON L.,
VARDEMAN LINDA,
GOLDSTEIN SHAWN
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.tb06878.x
Subject(s) - medicine , heart failure , cardiology , heart rate , sinus rhythm , normal sinus rhythm , electrocardiography , hemodynamics , atrial fibrillation , blood pressure
LUCERI, R., ET AL.: PR Interval Behavior During Exercise: Implications for Physiological Pacemakers. The relationship between heart rate response and the dynamic changes in the PR interval was assessed in 631 patients undergoing routine cardiac exercise tests for a variety of clinical indications. Patients were stratified into four subsets: nonmedicated normals [n = 437), patients on beta‐antagonist agents (n = 118), those on antiarrhythmic agents alone (n = 62) and those with a clinical diagnosis of advanced (New York Heart Association [NYHA] Class 111 or IV) congestive heart failure. All patients were in stable sinus rhythm throughout the test. PR intervals were measured at rest, at mid‐exercise and at peak exercise. Mean PR intervals shortened to a statistically significant degree in most subgroups. This effect was predominantly observed in the earlier stages of exercise. In patients with advanced heart failure, there was no statistically significant shortening of exercise PR intervals later in exercise, demonstrating a parallel with their relatively blunted heart rate response. These changes in exercise PR intervals suggest that implanted pacemaker algorithms may be constructed to maximize hemodynamic benefit in patients requiring physiological pacemakers.