What question did this study set out to answer?

The study aims to compare hemodynamic profiles between dual chamber pacing and activity sensing rate responsive pacing during exercise.

December 1, 1990Pacing and Clinical Electrophysiology

Superior Cardiac Hemodynamics of Atrioventricular Synchrony Over Rate Responsive Pacing at Submaximal Exercise: Observations in Activity Sensing DDDR Pacemakers

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Why the study?

Does dual chamber pacing (DDD) improve cardiac output compared to activity sensing rate responsive pacing (VVIR) during submaximal exercise in patients with pacemakers?

Key Points

The study aims to compare hemodynamic profiles between dual chamber pacing and activity sensing rate responsive pacing during exercise.
Compared dual chamber pacing (DDD) and activity sensing rate responsive pacing (VVIR) in ten patients.
Implemented a double-blind, randomized exercise protocol with different pacing modes and AV intervals.
Cardiac output was assessed using continuous-wave Doppler during treadmill exercise tests.
Cardiac output was significantly higher with DDD pacing compared to VVIR at rest, during exercise, and recovery.
Resting cardiac output was 21% with DDD versus -2% with VVIR (P < 0.05).
Lowering the AV interval to 75 msec reduced post-exercise cardiac output significantly (2% vs 23%, P < 0.02).

Structured PICO

Does dual chamber pacing (DDD) improve cardiac output compared to activity sensing rate responsive pacing (VVIR) during submaximal exercise in patients with pacemakers?

Population

10 patients with dual chamber rate responsive pacemakers (Synergist II)

Intervention

Dual chamber pacing (DDD) mode with AV interval 150 msec (and 75 msec in 7 patients)

Comparator

Activity sensing rate responsive pacing (VVIR) mode and VVI mode

Outcome

Cardiac output assessed using continuous-wave Doppler sampling ascending aortic flow (expressed as a percentage of the value achieved during VVI pacing)surrogate

Atrioventricular synchrony (DDD pacing) provides superior cardiac output compared to rate responsive ventricular pacing (VVIR) during submaximal exercise.

Discussion

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Implication

Favors DDD over VVIR for hemodynamic gains during daily activity in pacemaker patients; confirms AV synchrony benefit versus rate-responsive ventricular pacing.

Cite This Study

Lau et al. (1990) studied this question.

synapsesocial.com/papers/6a21189b6bd086c0991e4a75 https://doi.org/10.1111/j.1540-8159.1990.tb06899.x

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Implication

Favors DDD over VVIR for hemodynamic gains during daily activity in pacemaker patients; confirms AV synchrony benefit versus rate-responsive ventricular pacing.

Superior Cardiac Hemodynamics of Atrioventricular Synchrony Over Rate Responsive Pacing at Submaximal Exercise: Observations in Activity Sensing DDDR Pacemakers

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Superior Cardiac Hemodynamics of Atrioventricular Synchrony Over Rate Responsive Pacing at Submaximal Exercise: Observations in Activity Sensing DDDR Pacemakers

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider