Deleterious Effects of Cardiac Pacing in a Patient with Mitral Insufficiency

Abstract

A 70‐year‐old, artificially paced woman with dizziness and extremely low physical capacity exhibited a systolic BP varying from one moment to another; in standing position it was not measurable. With the aid of a strain gauge technique, the amplitude of the pulse wave of her left thumb was recorded and shown to vary widely. The variations were correlated to synchrony or asynchrony between atrial and ventricular activity. Pronounced decreases in stroke volume and peripheral pulse volume were recorded with pacemaker‐induced beats compared with idioventricular beats. With artificial stimulation at a rate of 45/min, thus avoiding competition but still protecting her from syncopes, she was free from symptoms.

Non‐Invasive Beat‐to‐Beat Analysis of Stroke Volume and Digital Pulse Volume in Patients with Complete Heart Block and Artificial Pacing

“…The purpose of the study was: I ) To determine beat-to-beat variations of left ventricular end-diastolic diameter (LVEDD) and SV measured by echocardiography, and digital arterial pulse volume (DAPA) recorded plethysmographically; 2) to Most patients treated with artificial pacemakers for severe cardiac conduction disturbances obtain great benefit from this treatment. However, in some instances artificial pacing may have deleterious effects on both central and peripheral circulation (2). In these, atrioventricular (AV) dissociation may cause intermittent valvular incompetence when atrial systole occurs at a certain point during the ventricular contraction (8).…”