Influence of the pacing rate on the atrioventricular conduction time during aerobic and anaerobic exercise: basic concepts for a dromotropically controlled rate responsive pacemaker.
The dromotropic pacemaker concept needs a rate responsive algorithm in which the pacing rate is controlled by the atrioventricular conduction time (AVCT). To develop basic concepts for such a rate responsive algorithm, the influence of the pacing rate on the AVCT was investigated. Seven patients (62...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 22; no. 12; pp. 1782 - 1792 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec1999
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107114959&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107114959 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Dec1999 vid: 22 iid: 12 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 107114959 2000040222 10.1111/j.1540-8159.1999.tb00411.x NLM10642132 107114959 ppf: 1782 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Influence of the pacing rate on the atrioventricular conduction time during aerobic and anaerobic exercise: basic concepts for a dromotropically controlled rate responsive pacemaker. aug: au: Meine M Hexamer M Werner J Israel CW Mügge A Lemke B Barmeyer J affil: Dept of Biomedical Engineering of the Medical Faculty, Ruhr-University, Bochum, Germany sug: subj: Atrioventricular Node Physiopathology Cardiac Pacing, Artificial Methods Exercise Physiology Anaerobic Threshold Exercise Test, Cardiopulmonary Treadmills Heart Rate Physiology Electrocardiography Oxygen Consumption Sick Sinus Syndrome Physiopathology Sick Sinus Syndrome Therapy Time Factors Pearson's Correlation Coefficient Regression Paired T-Tests Two-Tailed Test Human ab: The dromotropic pacemaker concept needs a rate responsive algorithm in which the pacing rate is controlled by the atrioventricular conduction time (AVCT). To develop basic concepts for such a rate responsive algorithm, the influence of the pacing rate on the AVCT was investigated. Seven patients (62 +/- 7.8 years) with sick sinus syndrome and intact atrioventricular conduction underwent two cardiopulmonary exercise tests (CPX) on a treadmill. According to the determination of the anaerobic threshold (AT) and the patients maximum capacity in the first incremental CPX the work rate for two exercise levels below and above the AT were chosen for the second constant workload CPX. The calculation of the optimal pacing rate (HRopt) was based on the oxygen uptake (VO2) during exercise after reaching steady-state conditions. According to the increase of the VO2 from 14.8 +/- 2.3 mL/min per kilogram during aerobic work (38.3 +/- 16.0 W) to 19.4 +/- 4.7 mL/min per kilogram during anaerobic work (80.6 +/- 32.3 W), the HRopt was calculated to be 98.6 +/- 6.9 beats/min and 116.4 +/- 4.7 beats/min. Starting from HRopt, the pacing rate was increased (overpacing) and decreased (underpacing) by about 5 beats/min every minute. At optimal pacing rate the AVCT decreased significantly from 233.0 +/- 30.5 ms during aerobic work and to 226.4 +/- 27.3 ms during anaerobic work (P < 0.05). Whereas overpacing induced a significant prolongation of the AVCT during aerobic work (4.17 +/- 1.78 ms per 10 beats/min) and anaerobic work (3.84 +/- 1.60 ms per 10 beats/min), underpacing yielded a significant shortening of the AVCT by about 4.49 +/- 2.64 ms per 10 beats/min during aerobic work and 4.75 +/- 1.87 ms per 10 beats/min during anaerobic work (P < 0.01). The slopes of the regression lines of the relationship between AVCT and pacing rate were not significantly. different. Based on the reciprocal relationship of heart rate (HR) and AVCT, basic concepts may be established for a dromotropic rate responsive algorithm. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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