Optimal pacemaker programming with AV synchrony and controlled rate adaptation is beneficial for patients with CAD and angina, facilitating aggressive medical therapy when interventions are unsuitable.
Supports optimized AV-synchronous rate-adaptive pacing in CAD with angina; leaves open need for randomized confirmation.
Pacemaker patients with coronary artery disease and angina pectoris fare better with devices providing AV synchrony and rate increase on exercise provided the programmed upper rate is not excessive. Optimal programming requires knowledge of the factors influencing pacemaker rate response, MVO2 and cardiac sympathetic activity. Inappropriately high rates during rate adaptive pacing can be controlled by new multisensor systems with sensor cross-checking to avoid false positive responses with inappropriate increases in the pacing rate. Permanent pacing in patients with intractable angina who are unsuitable for interventional procedures permits more aggressive pharmacological therapy.
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Barold et al. (1998) studied this question.
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