Key result
Donor atrial pacing and donor atrial-ventricular sequential pacing improved resting cardiac output compared to right ventricular pacing in transplant recipients.
Why the study?
Do different pacing modes and synchronization of recipient and donor atria improve resting cardiac output in cardiac transplant recipients?
Do different pacing modes and synchronization of recipient and donor atria improve resting cardiac output in cardiac transplant recipients?
In cardiac transplant recipients, donor atrial or atrial-ventricular sequential pacing improves resting cardiac output compared to right ventricular pacing, but synchronizing recipient and donor atria offers no additional benefit.
Answers are grounded in this paper and cite their sources.
May support atrial pacing modes to augment output in transplant recipients; leaves open need for randomized outcome trials.
OBJECTIVE: To investigate the response of the transplanted heart to different pacing modes and to synchronisation of the recipient and donor atria in terms of cardiac output at rest. DESIGN: Doppler derived cardiac output measurements at three pacing rates (90/min, 110/min and 130/min) in five pacing modes: right ventricular pacing, donor atrial pacing, recipient-donor synchronous pacing, donor atrial-ventricular sequential pacing, and synchronous recipient-donor atrial-ventricular sequential pacing. PATIENTS: 11 healthy cardiac transplant recipients with three pairs of epicardial leads inserted at transplantation. RESULTS: Donor atrial pacing (+11% overall) and donor atrial-ventricular sequential pacing (+8% overall) were significantly better than right ventricular pacing (p < 0.001) at all pacing rates. Synchronised pacing of recipient and donor atrial segments did not confer additional benefit in either atrial or atrial-ventricular sequential modes of pacing in terms of cardiac output at rest at these fixed rates. CONCLUSIONS: Atrial pacing or atrial-ventricular sequential pacing appear to be appropriate modes in cardiac transplant recipients. Synchronisation of recipient and donor atrial segments in this study produced no additional benefit. Chronotropic competence in these patients may, however, result in improved exercise capacity and deserves further investigation.
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Parry et al. (1992) studied Cardiac transplant recipients (n=11). Donor atrial pacing and donor atrial-ventricular sequential pacing vs. Right ventricular pacing was evaluated on Cardiac output at rest (p=<0.001). Donor atrial pacing and donor atrial-ventricular sequential pacing improved resting cardiac output compared to right ventricular pacing in transplant recipients.
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