Characteristics of the Acute Rise of Atrial Natriuretic Factor During Ventricular Pacing

Zullo, Michael A.

doi:10.1378/chest.121.6.1942

“…The exercise increase in NP concentration was related to the increase in HR at exercise. Previous studies performed during spontaneous tachycardia or ventricular pacing have already provided evidence that a prompt rise in HR was a potent trigger of the acute release of BNP and especially of that of ANP (23,24). However, the present study shows that this impact of HR is not the same when patients are treated with beta-blockers.…”

Section: Discussioncontrasting

confidence: 81%

Exercise release of cardiac natriuretic peptides is markedly enhanced when patients with coronary artery disease are treated medically by beta-blockers

Marie¹,

Mertès²,

Hassan-Sebbag³

et al. 2004

Journal of the American College of Cardiology

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Physiologic VDD versus Nonphysiologic VVI Pacing in Canine 3rd‐Degree Atrioventricular Block

Bulmer

¹

,

Sisson

²

,

Oyama

³

et al. 2006

Veterinary Internal Medicne

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Historically, ventricular demand, nonphysiologic (VVI) pacing has been the most commonly used modality to treat 3rd-degree atrioventricular (AV) block. The goal of this study was to determine the feasibility of using a commercial, single-lead, physiologic (VDD) pacemaker in dogs with 3rd-degree AV block. Furthermore, we hoped to characterize and identify differences in the radiographic, echocardiographic, neurohormonal, and quality of life consequences of physiologic versus nonphysiologic pacing. We evaluated 10 dogs during a 12-week crossover study. Acutely, rate-matched physiologic pacing reduced pulmonary capillary wedge pressure by 19% compared with nonphysiologic pacing. VDD pacing significantly reduced left atrial size normalized to body weight, left atrial-to-aortic root ratio, and left ventricular end-systolic dimension and increased fractional shortening, aortic Doppler velocity, cardiac output, and stroke volume compared with VVI pacing. Variable rate VDD pacing resulted in a significantly slower heart rate (HR) during echocardiography than fixed-rate (100 bpm) VVI pacing. AV synchronous pacing reduced circulating N-terminal proatrial natriuretic peptide (ANP), norepinephrine (NOR), and epinephrine (EPI) concentrations compared with asynchronous pacing. There were no significant differences in systemic blood pressure, thoracic radiographs, or owner-perceived quality of life. The median percentage of AV synchronous pacing during the VDD modality was 99.8% (range, 1.2 to 99.9%). This study confirms the potential to achieve physiologic pacing with a commercial, single-lead system in dogs. VDD pacing improved hemodynamics and neurohormonal profiles over asynchronous pacing although the long-term clinical benefits of these changes remain to be determined.

show abstract

Physiologic VDD Versus Nonphysiologic VVI Pacing In Canine 3rd-Degree Atrioventricular Block

Bulmer¹,

Sisson²,

Oyama³

et al. 2006

View full text Add to dashboard Cite

Historically, ventricular demand, nonphysiologic (VVI) pacing has been the most commonly used modality to treat 3rd-degree atrioventricular (AV) block. The goal of this study was to determine the feasibility of using a commercial, single-lead, physiologic (VDD) pacemaker in dogs with 3rd-degree AV block. Furthermore, we hoped to characterize and identify differences in the radiographic, echocardiographic, neurohormonal, and quality of life consequences of physiologic versus nonphysiologic pacing. We evaluated 10 dogs during a 12-week crossover study. Acutely, rate-matched physiologic pacing reduced pulmonary capillary wedge pressure by 19% compared with nonphysiologic pacing. VDD pacing significantly reduced left atrial size normalized to body weight, left atrial-to-aortic root ratio, and left ventricular end-systolic dimension and increased fractional shortening, aortic Doppler velocity, cardiac output, and stroke volume compared with VVI pacing. Variable rate VDD pacing resulted in a significantly slower heart rate (HR) during echocardiography than fixed-rate (100 bpm) VVI pacing. AV synchronous pacing reduced circulating N-terminal proatrial natriuretic peptide (ANP), norepinephrine (NOR), and epinephrine (EPI) concentrations compared with asynchronous pacing. There were no significant differences in systemic blood pressure, thoracic radiographs, or owner-perceived quality of life. The median percentage of AV synchronous pacing during the VDD modality was 99.8% (range, 1.2 to 99.9%). This study confirms the potential to achieve physiologic pacing with a commercial, single-lead system in dogs. VDD pacing improved hemodynamics and neurohormonal profiles over asynchronous pacing although the long-term clinical benefits of these changes remain to be determined.

show abstract

Characteristics of the Acute Rise of Atrial Natriuretic Factor During Ventricular Pacing

Cited by 3 publications

References 34 publications

Exercise release of cardiac natriuretic peptides is markedly enhanced when patients with coronary artery disease are treated medically by beta-blockers

Exercise release of cardiac natriuretic peptides is markedly enhanced when patients with coronary artery disease are treated medically by beta-blockers

Physiologic VDD versus Nonphysiologic VVI Pacing in Canine 3rd‐Degree Atrioventricular Block

Physiologic VDD Versus Nonphysiologic VVI Pacing In Canine 3rd-Degree Atrioventricular Block

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