What question did this study set out to answer?

To examine the negative effects of cardiac pacing on heart function in a patient with mitral insufficiency.

January 12, 1977Acta Medica Scandinavica

Deleterious Effects of Cardiac Pacing in a Patient with Mitral Insufficiency

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Why the study?

Does adjusting artificial pacing rate to 45/min improve symptoms and hemodynamics in a patient with mitral insufficiency and pacemaker-induced asynchrony?

Key Points

To examine the negative effects of cardiac pacing on heart function in a patient with mitral insufficiency.
Case report of a 70-year-old woman with mitral insufficiency undergoing cardiac pacing.
Assessment of blood pressure and pulse wave amplitude using a strain gauge technique.
Comparison of stroke volume and pulse volume during pacemaker-induced and idioventricular beats.
Systolic blood pressure was not measurable in a standing position.
Decreased stroke volume and peripheral pulse volume found with pacemaker-induced beats compared to idioventricular beats.
Patient remained symptom-free with pacing at a controlled rate of 45/min.

Structured PICO

Does adjusting artificial pacing rate to 45/min improve symptoms and hemodynamics in a patient with mitral insufficiency and pacemaker-induced asynchrony?

Population

A 70-year-old woman with an artificial pacemaker, mitral insufficiency, dizziness, and extremely low physical capacity (n=1)

Intervention

Artificial pacing at a rate of 45/min

Comparator

Pacemaker-induced beats versus idioventricular beats

Outcome

Symptoms (dizziness, physical capacity), stroke volume, peripheral pulse volume, and systolic blood pressuresurrogate

In a patient with mitral insufficiency, pacemaker-induced beats can cause severe hemodynamic compromise due to atrioventricular asynchrony, which can be managed by lowering the pacing rate to avoid competition.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May support rate reduction to ease symptoms in similar asynchrony; leaves open confirmation in prospective studies.

Cite This Study

Edhag et al. (1977) studied this question.

synapsesocial.com/papers/6a20e4fac9150832be180d1a https://doi.org/10.1111/j.0954-6820.1977.tb16838.x

Topics

Mitral valve intervention

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Deleterious Effects of Cardiac Pacing in a Patient with Mitral Insufficiency

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Deleterious Effects of Cardiac Pacing in a Patient with Mitral Insufficiency

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider