RT-38
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Long term clinical evaluation of
VDD pacing with a single pass lead
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L. Pavia, G. Cannava, C.
Silipigni, F. Casella, A. Cordiani, F.N. Longo.
Cardiac Pacing Section, Department of Cardiology, "Azienda Piemonte Hospital",
Messina, Italy
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Introduction
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The automatic adaptation of pacing rate and the
preservation of AV synchronism produce important hemodynamic benefits in elderly patients
with AV and ischemic or hypertensive heart disease.
The cardiac output is the product of systolic volume and heart rate. The systolic
volume is determined by the residual systolic volume and the telediastolic volume which
are related to the contractility, afterload, to the compliance and to the filling
pressure. The heart rate depends on the sinus activity and the AV synchronism. In the
paced patient the automatic pacing rate adjustement, the AV synchronism, the AV variable
according to the sensing and pacing rate and the pacing lead position become very
important.
In determining the pacing mode to choose the following points should be considered:
1) the electrical and mechanical condition of the atrium;
2) the sinus function response to exercise;
3) the AV conduction quality;
4) the ventricular function quality.
The VDD single lead stimulation guided by spontaneous atrial activity with normal AV
sequence would be the first choice for patient with differnt degrees of AV block and
normal sinus rhythm.
The aim of this study was to evaluate the new pacing system by assessing evaluating
the appropriate P-wave sensing in different patient positions (supine, sitting, standing,
deep breath) and during long-term follow-up.
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