What does this research mean for the field?

In patients with complete atrioventricular block, AV synchronous pacing with auto-AV delay results in lower peak exercise plasma norepinephrine levels than fixed AV delay, despite persistent sympathetic hyperactivation relative to healthy controls. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

December 1, 1990Pacing and Clinical Electrophysiology

Sympathetic Nervous System Response to Dynamic Exercise in Complete AV Block Patients Treated with AV Synchronous Pacing with Fixed AV Delay or with Auto‐AV Delay

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Complete atrioventricular block (CAVB) (n=20). Intervention: AV synchronous pacing with auto-AV delay vs. Fixed AV delay and normal subjects. Primary outcome: Plasma norepinephrine (NE) levels and circulatory parameters at rest, peak exercise, and recovery.

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Key result

Auto-AV delay linked to lower exercise norepinephrine levels versus fixed AV delay in CAVB patients.

n=20

Why the study?

The sympathetic nervous system and circulatory responses to exercise in complete atrioventricular block patients treated with AV synchronous pacing with fixed versus auto-AV delay were not well characterized.

Does AV synchronous pacing with auto-AV delay improve sympathetic nervous system and circulatory responses to exercise compared to fixed AV delay in patients with complete AV block?

Comparison

AV synchronous pacing with fixed AV delay versus auto-AV delay

Design

Observational study with symptom-limited multistaged treadmill stress test

Authors

OIOsamu IgawaNihon University ATAkira TomokuniOsaka Prefectural Medical Center MSMakoto SaitohChiba University

Discussion

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Implication

May support auto-AVD to limit exercise sympathetic activation in CAVB; hypothesis-generating and requires prospective validation.

Study Design

Type

Observational (n=20)

Structured PICO

Does AV synchronous pacing with auto-AV delay improve sympathetic nervous system and circulatory responses to exercise compared to fixed AV delay in patients with complete AV block?

Population

8 patients with complete atrioventricular block treated with AV synchronous pacing and 12 normal subjects who underwent a symptom-limited, multistaged treadmill stress test.

Exposure

AV synchronous pacing with auto-atrioventricular delay (auto-AVD) during a symptom-limited, multistaged treadmill stress test (applied to 3 of the 8 patients).

Comparator

AV synchronous pacing with fixed AV interval (150 or 156 msec) during the same stress test protocol.

Outcome

Plasma norepinephrine (NE) levels and circulatory parameters (systolic blood pressure, heart rate) at rest, at peak exercise, and in the recovery period.surrogate

AV synchronous pacing with auto-AV delay appears to improve the sympathetic nervous system response to exercise compared to fixed AV delay in patients with complete AV block.

Cite This Study

Igawa et al. (1990) conducted an observational in Complete atrioventricular block (CAVB) (n=20). AV synchronous pacing with auto-AV delay vs. Fixed AV delay and normal subjects was evaluated on Plasma norepinephrine (NE) levels and circulatory parameters at rest, peak exercise, and recovery. Plasma norepinephrine levels during exercise were significantly higher in CAVB patients with fixed AV delay compared to normal subjects, but were lower when using auto-AV delay.

synapsesocial.com/papers/6ab0cc527f8ce164d65fcce1 https://doi.org/10.1111/j.1540-8159.1990.tb06887.x

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Sympathetic Nervous System Response to Dynamic Exercise in Complete AV Block Patients Treated with AV Synchronous Pacing with Fixed AV Delay or with Auto‐AV Delay

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Sympathetic Nervous System Response to Dynamic Exercise in Complete AV Block Patients Treated with AV Synchronous Pacing with Fixed AV Delay or with Auto‐AV Delay

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Also Consider

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