Right ventricular pacing during isoproterenol stimulation resulted in significantly smaller increases in left ventricular dP/dt and cardiac output compared to sinus rhythm or right atrial pacing (p<0.025).
Does right ventricular pacing compared to right atrial pacing or sinus rhythm alter myocardial performance during inotropic stimulation in a canine model?
Right ventricular pacing impairs the expected increase in myocardial performance and increases myocardial oxygen consumption during inotropic stimulation compared to right atrial pacing or sinus rhythm.
p-value: p=<0.025
The effects of altering the site of electrical activation on responses to isoproterenol (ISO) and treadmill exercise were examined in mongrel dogs instrumented for long-term measurement of left ventricular pressure, left ventricular dP/dt, coronary blood flow, cardiac output, left ventricular diameters, and mean arterial pressure and O2 content in the coronary sinus and aorta. During spontaneous rhythm, 0.2 micrograms/kg/min ISO increased heart rate by 90 +/- 7 beats/min, left ventricular dP/dt by 2479 +/- 301 mm Hg/sec, cardiac output by 3.5 +/- 0.9 liters/min, coronary blood flow by 30.4 +/- 3.9 ml/min, and myocardial oxygen consumption (MVO2) by 3.91 +/- 0.84 ml/min. During right atrial pacing at 193 +/- 7 beats/min, the effects of ISO were not different from the effects during spontaneous rhythm, with the exception of a lesser increase in coronary blood flow and lesser reductions in coronary resistance and left ventricular end-diastolic diameter and pressure. During right ventricular pacing at an identical rate, ISO increased left ventricular dP/dt (1140 +/- 158 mm Hg/sec) and cardiac output (2.2 +/- 0.5 liters/min) significantly less (p less than .025) than during either sinus rhythm or right atrial pacing, while MVO2 rose to a higher value. During right ventricular pacing the changes in mean arterial pressure and left ventricular end-diastolic diameters with ISO were not significantly different from those during right atrial pacing. Treadmill exercise induced significantly smaller (p less than .025) increases in left ventricular dP/dt during right ventricular pacing as compared with during either right atrial pacing or sinus rhythm, while MVO2 rose to a higher value.(ABSTRACT TRUNCATED AT 250 WORDS)
Heyndrickx et al. (Wed,) conducted a other in Myocardial performance during inotropic stimulation. Right ventricular pacing with isoproterenol or treadmill exercise vs. Spontaneous rhythm and right atrial pacing was evaluated on Left ventricular dP/dt and cardiac output (p=<0.025). Right ventricular pacing during isoproterenol stimulation resulted in significantly smaller increases in left ventricular dP/dt and cardiac output compared to sinus rhythm or right atrial pacing (p<0.025).