Determination of the Optimal Atrioventricular Interval in Sick Sinus Syndrome During DDD Pacing

Kato, Masaya; Dote, Keigo; Sasaki, Shota; Goto, Kenji; Takemoto, Hiroaki; Habara, Seiji; Hasegawa, Daiji; Matsuda, Osamu

doi:10.1111/j.1540-8159.2005.00210.x

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…We are not sure whether relying only on echocardiographic assessment is the gold standard. However, we selected this strategy because previous studies also set AV delay based on echocardiographic findings [8][9][10][11][12][13].…”

Section: Limitationsmentioning

confidence: 99%

“…Regarding pacemakers for bradycardia, some studies have reported on the optimization of AV delay [8][9][10][11][12][13]. However, it remains unknown whether intrinsic AV conduction with delays in AV conduction time exceeding physiological levels (corresponding to first-degree AV block) should be preserved or ventricular pacing with AV delay within physiological levels should be delivered to obtain better LV function.…”

Section: Introductionmentioning

confidence: 99%

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AV timing in pacemaker patients with first-degree AV block: which is preferable, intrinsic AV conduction or pacing?

et al. 2022

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Some patients with pacemakers present with first-degree atrioventricular (AV) block. To avoid right ventricular (RV) pacing, preserving intrinsic AV conduction as much as possible is recommended. However, there is no clear cutoff AV interval to determine whether intrinsic AV conduction should be preserved or RV pacing should be delivered. This study aimed to compare a pacing mode-preserving, intrinsic AV conduction with the DDD mode delivering RV pacing in terms of echocardiographic parameters in patients with first-degree AV block and to investigate whether RV pacing induces heart failure (HF). Stroke volume (SV) was measured to determine the optimal AV delay with the intrinsic AV conduction rhythm and the DDD pacing delivering RV pacing. Echocardiographic evaluation was performed for 6-month follow-up period. Seventeen patients were studied. At baseline, mean intrinsic PQ interval was 250 ± 40 ms. SV was greater with RV pacing with optimal AV delay of 160 ms than with intrinsic AV conduction rhythm in all patients. Therefore, pacemakers were set to the DDD to deliver RV pacing. During follow-up, seven patients developed HF. Mean baseline E/E′ ratio in patients who developed HF (HF group) during RV pacing was higher than in patients without HF (non = HF group; 17.9 ± 8 versus 11.5 ± 2, P = 0.018) Even within HF group patients without a high baseline E/E′ ratio, it increased with RV pacing (22.2 ± 6 versus 11.6 ± 2; P < 0.001). In patients with pacemaker and first-degree AV block, RV pacing with the optimal AV delay of 160 ms increased SV. However, the risk of HF may be increased with RV pacing if the E/Eʹ ratio is > 15 during intrinsic AV conduction or RV pacing. RV pacing should be avoided in patients with high E/Eʹ ratio under intrinsic AV conduction or RV pacing.

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Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

AV timing in pacemaker patients with first-degree AV block: which is preferable, intrinsic AV conduction or pacing?

et al. 2022

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“…In patients with dual chamber pacemakers, ventricular activation achieved via synchronisation between atria and ventricles is necessary to simulate normal cardiac physiology [1]. Achievement of this synchronisation is possible by optimal setting of atrioventricular (AV) delay time.…”

Section: Introductionmentioning

confidence: 99%

Automated functional imaging in atrioventricular delay time optimisation in patients with dual chamber pacemakers

et al. 2014

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“…A manutenção do sincronismo atrioventricular tem sido reconhecida como um dos principais fatores que favorecem o desempenho cardíaco durante a estimulação cardíaca permanente, pela contribuição da sístole atrial no enchimento ventricular e por minimizar a regurgitação mitral [4][5][6] . O somatório desses fatores tornaram a estimulação atrioventricular como a principal opção dentre todos os modos de estimulação cardíaca artificial 1,2 .…”

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Estudo da segurança e da estabilidade do implante de cabo-eletrodo atrial direito pela via epidemiocárdiaca através do seio transverso em modelo animal suíno

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Determination of the Optimal Atrioventricular Interval in Sick Sinus Syndrome During DDD Pacing

Abstract: Even though the intrinsic AV conduction is moderately prolonged, some SSS patients with dual-chamber pacing devices benefit from the ventricular pacing with optimal AV interval. MPI is useful to determine the optimal pacing mode in acute experiment.

Cited by 5 publications

References 28 publications

AV timing in pacemaker patients with first-degree AV block: which is preferable, intrinsic AV conduction or pacing?

AV timing in pacemaker patients with first-degree AV block: which is preferable, intrinsic AV conduction or pacing?

Automated functional imaging in atrioventricular delay time optimisation in patients with dual chamber pacemakers

Estudo da segurança e da estabilidade do implante de cabo-eletrodo atrial direito pela via epidemiocárdiaca através do seio transverso em modelo animal suíno

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