The influence and clinical consequences of different atrioventricular delays on ventricular filling have been studied in 30 patients (mean age 60 +/- 5 years) who implanted DDD pacemaker for complete A-V block. All patients presented a normal ejection fraction: 63.9 +/- 6.5%. In 18 subjects (Group I) an echo-Doppler examination revealed ventricular hypertrophy (mean end-diastolic wall thickness of 1.4 +/- 0.16 cm; left ventricular mass index 155 +/- 17 g/m2) and an abnormal relaxation pattern (isovolumic relaxation time 124 +/- 11: early to late peak velocity 0.6 +/- 0.03; deceleration time of the early diastolic peak 296 +/- 34 ms). Group II included the remaining 12 patients without left ventricular hypertrophy and normal filling pattern. In all 30 patients the filling pattern was reassessed following modification of the A-V delay (200, 150, 100 and 75 ms). Patients at baseline (200 ms of A-V delay) underwent an exercise test with determination of respiratory gas exchange. In Group I, 13 (72.5%) patients were classified as Weber class B (VO2 max 16.8 +/- 1.7 ml/min/kg) and 5 (27.5%) as class A (VO2 max 22.5 +/- 1.4 ml/min/kg). In Group II, all 12 patients were classified as Weber class A (VO2 max 23.1 +/- 1.1 ml/ min/kg). In Group II, changes in A-V delay caused no homogeneous variation in filling pattern. A-V delay was not modified in this group. In Group I, the reduction of A-V delay to 100 ms resulted in filling normalization. In this group A-V delay was programmed definitely to 100 ms. Graded exercise test repeated at 6 months follow-up showed an improved Weber class in 13 patients (from B to A) and greater VO2 max in the remaining 5 already in class A. We conclude that, in sequential paced patients with normal ejection fraction but abnormal relaxation pattern, a modification of A-V delay can induce filling normalization and improve cardiac functional capacity

Shortening of atrioventricular interval improves ventricular filling and clinical outcome in patients with DDD pacemaker and left ventricular hypertrophy [L’accorciamento dell’intervallo atrio-ventricolare migliora il riempimento ventricolare e il quadro clinico in pazienti con pace-maker DDD e ipetrofia ventricolare sinistra] / Rossi, Rosario; Molinari, R; Carcagnì, A; Mattioli, Anna Vittoria; Modena, Maria Grazia. - In: CARDIOLOGIA. - ISSN 0393-1978. - ELETTRONICO. - 41:(1996), pp. 441-447.

Shortening of atrioventricular interval improves ventricular filling and clinical outcome in patients with DDD pacemaker and left ventricular hypertrophy [L’accorciamento dell’intervallo atrio-ventricolare migliora il riempimento ventricolare e il quadro clinico in pazienti con pace-maker DDD e ipetrofia ventricolare sinistra]

ROSSI, Rosario;MATTIOLI, Anna Vittoria;MODENA, Maria Grazia
1996

Abstract

The influence and clinical consequences of different atrioventricular delays on ventricular filling have been studied in 30 patients (mean age 60 +/- 5 years) who implanted DDD pacemaker for complete A-V block. All patients presented a normal ejection fraction: 63.9 +/- 6.5%. In 18 subjects (Group I) an echo-Doppler examination revealed ventricular hypertrophy (mean end-diastolic wall thickness of 1.4 +/- 0.16 cm; left ventricular mass index 155 +/- 17 g/m2) and an abnormal relaxation pattern (isovolumic relaxation time 124 +/- 11: early to late peak velocity 0.6 +/- 0.03; deceleration time of the early diastolic peak 296 +/- 34 ms). Group II included the remaining 12 patients without left ventricular hypertrophy and normal filling pattern. In all 30 patients the filling pattern was reassessed following modification of the A-V delay (200, 150, 100 and 75 ms). Patients at baseline (200 ms of A-V delay) underwent an exercise test with determination of respiratory gas exchange. In Group I, 13 (72.5%) patients were classified as Weber class B (VO2 max 16.8 +/- 1.7 ml/min/kg) and 5 (27.5%) as class A (VO2 max 22.5 +/- 1.4 ml/min/kg). In Group II, all 12 patients were classified as Weber class A (VO2 max 23.1 +/- 1.1 ml/ min/kg). In Group II, changes in A-V delay caused no homogeneous variation in filling pattern. A-V delay was not modified in this group. In Group I, the reduction of A-V delay to 100 ms resulted in filling normalization. In this group A-V delay was programmed definitely to 100 ms. Graded exercise test repeated at 6 months follow-up showed an improved Weber class in 13 patients (from B to A) and greater VO2 max in the remaining 5 already in class A. We conclude that, in sequential paced patients with normal ejection fraction but abnormal relaxation pattern, a modification of A-V delay can induce filling normalization and improve cardiac functional capacity
1996
41
441
447
Shortening of atrioventricular interval improves ventricular filling and clinical outcome in patients with DDD pacemaker and left ventricular hypertrophy [L’accorciamento dell’intervallo atrio-ventricolare migliora il riempimento ventricolare e il quadro clinico in pazienti con pace-maker DDD e ipetrofia ventricolare sinistra] / Rossi, Rosario; Molinari, R; Carcagnì, A; Mattioli, Anna Vittoria; Modena, Maria Grazia. - In: CARDIOLOGIA. - ISSN 0393-1978. - ELETTRONICO. - 41:(1996), pp. 441-447.
Rossi, Rosario; Molinari, R; Carcagnì, A; Mattioli, Anna Vittoria; Modena, Maria Grazia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/598191
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