July 1, 1987Pacing and Clinical Electrophysiology
Noninvasive Assessment by Doppler and M‐Mode Echocardiography of Hemodynamic Responses to Temporary Pacing and to Ventriculoatrial Conduction
Key result
AV sequential pacing provided a 17% to 35% higher cardiac output compared to ventricular pacing across patient groups, demonstrating it as the preferred temporary pacing mode.
Why the study?
Does AV sequential temporary pacing improve cardiac output compared to ventricular pacing or spontaneous rhythm in patients requiring temporary pacemakers?
Population
20 patients who needed a temporary pacemaker, divided into three groups: no valvular heart disease and no…
Comparison
AV sequential pacing at a positive AV interval… vs Spontaneous rhythm, ventricular pacing, and AV…
Design
Case_series
Authors
Discussion
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Implication
May support AV sequential pacing for hemodynamic benefit in temporary pacing; hypothesis-generating and requires randomized confirmation.
Key Points
- To evaluate hemodynamic performance across different temporary pacing modes and assess the impact of ventriculoatrial conduction using noninvasive echocardiography.
- Studied 20 patients requiring temporary pacemakers using a dual-chamber lead introduced via the subclavian vein.
- Measured stroke volume, left ventricular dimensions, and valvular function via combined M-mode and Doppler echocardiography during spontaneous rhythm, dual-chamber sequential pacing, ventricular pacing, and ventriculoatrial pacing.
- Categorized patients into three cohorts: without valvular disease or ventriculoatrial conduction (Group I, n=9), with valvular disease and no ventriculoatrial conduction (Group II, n=7), and with spontaneous ventriculoatrial conduction (Group III, n=4).
- In Group I, cardiac output increased 83 ± 11% with dual-chamber pacing versus 42 ± 9% with ventricular pacing compared to spontaneous rhythm, yielding 29 ± 3% higher output during dual-chamber pacing.
- In Group II, cardiac output increased 53 ± 12% with dual-chamber pacing versus 31 ± 11% with ventricular pacing compared to spontaneous rhythm, representing a 17 ± 4% advantage for dual-chamber pacing.
- In Group III, dual-chamber pacing generated 35 ± 10% greater cardiac output than ventricular pacing, with ventriculoatrial conduction causing a mean 20% reduction in cardiac output during ventricular pacing.
Study Design
Type
Observational (n=20)
Structured PICO
Does AV sequential temporary pacing improve cardiac output compared to ventricular pacing or spontaneous rhythm in patients requiring temporary pacemakers?
P
Population
20 patients who needed a temporary pacemaker, divided into three groups: no valvular heart disease and no ventriculoatrial (VA) conduction (n=9), valvular heart disease and no VA conduction (n=7), and spontaneous VA conduction (n=4).
I
Intervention
AV sequential pacing at a positive AV interval (DP) using a dual-chamber temporary pacing lead introduced via the subclavian vein.
C
Comparator
Spontaneous rhythm (SR), ventricular pacing (VP), and AV sequential pacing at a negative AV interval (VA pacing).
O
Outcome
Stroke volume (SV) and cardiac output (CO) measured continuously by combining M-mode and noninvasive Doppler echocardiography.surrogate
AV sequential pacing provides superior hemodynamic benefits, including higher cardiac output, compared to ventricular pacing in patients requiring temporary pacemakers.
Cite This Study
Færestrand et al. (1987) conducted an observational in Patients needing a temporary pacemaker (n=20). AV sequential pacing (DP) vs. Ventricular pacing (VP) and spontaneous rhythm (SR) was evaluated on Cardiac output (CO). AV sequential pacing provided a 17% to 35% higher cardiac output compared to ventricular pacing across patient groups, demonstrating it as the preferred temporary pacing mode.