Hemodynamic and Symptomatic Consequences of Ventricular Pacing

Rick A. Nishimura, Bernard J. Gersh, Ronald E. Vlietstra, Michael J. Osborn, Duane M. Ilstrup, David Holmes

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

NISHIMURA, R.A. et al.: Hemodynamic and symptomatic consequences of ventricular pacing. After implantation of a ventricular demand pacemaker (VVI), occasional patients continue to have dizziness, syncope, or near syncope (“pacemaker syndrome”). To identify patients in whom VVI pacing may have deleterious effects, we compared cuff blood pressure responses to VVI pacing with blood pressure responses to atrioventricsler sequential pacing (DVI) or sinus rhythm in 50 consecutive patients. Patients with intact ventriculoatrial conduction had a much greater decrease in systolic blood pressure with VVI pacing (24 ± 11 mm Hg) than those with ventriculoatrial dissociation (−4 ± 15 mm Hg) (P<0.005). Patients who were in heart failure had a lesser decrease in blood pressure with VVI pacing than did those without failure (P<0.05); 13 of the 14 heart failure patients lacked ventriculoatrial conduction. Ten patients had symptomatic dizziness after VVI pacing; the incidence of symptoms was higher in patients with ventriculoatrial conduction (9 of 23) than in those without ventriculoatrial conduction (1 of 27) (P<0.003). We conclude that the presence of intact ventriculoatrial conduction appears to be a crucial determinent of the hemodynamic response to VVI pacing, and its presence may identify patients who are at risk for “pacemaker syndrome.”

Original languageEnglish (US)
Pages (from-to)903-910
Number of pages8
JournalPacing and Clinical Electrophysiology
Volume5
Issue number6
DOIs
StatePublished - Jan 1 1982

Fingerprint

Hemodynamics
Blood Pressure
Syncope
Dizziness
Heart Failure
Dissociative Disorders
Incidence

Keywords

  • atrioventricular synchrony
  • dual‐chamber pacing
  • pacemaker syndrome
  • permanent pacing
  • ventriculer demand pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hemodynamic and Symptomatic Consequences of Ventricular Pacing. / Nishimura, Rick A.; Gersh, Bernard J.; Vlietstra, Ronald E.; Osborn, Michael J.; Ilstrup, Duane M.; Holmes, David.

In: Pacing and Clinical Electrophysiology, Vol. 5, No. 6, 01.01.1982, p. 903-910.

Research output: Contribution to journalArticle

Nishimura, Rick A. ; Gersh, Bernard J. ; Vlietstra, Ronald E. ; Osborn, Michael J. ; Ilstrup, Duane M. ; Holmes, David. / Hemodynamic and Symptomatic Consequences of Ventricular Pacing. In: Pacing and Clinical Electrophysiology. 1982 ; Vol. 5, No. 6. pp. 903-910.
@article{a3bddea63e034527aa55fae1944d36d3,
title = "Hemodynamic and Symptomatic Consequences of Ventricular Pacing",
abstract = "NISHIMURA, R.A. et al.: Hemodynamic and symptomatic consequences of ventricular pacing. After implantation of a ventricular demand pacemaker (VVI), occasional patients continue to have dizziness, syncope, or near syncope (“pacemaker syndrome”). To identify patients in whom VVI pacing may have deleterious effects, we compared cuff blood pressure responses to VVI pacing with blood pressure responses to atrioventricsler sequential pacing (DVI) or sinus rhythm in 50 consecutive patients. Patients with intact ventriculoatrial conduction had a much greater decrease in systolic blood pressure with VVI pacing (24 ± 11 mm Hg) than those with ventriculoatrial dissociation (−4 ± 15 mm Hg) (P<0.005). Patients who were in heart failure had a lesser decrease in blood pressure with VVI pacing than did those without failure (P<0.05); 13 of the 14 heart failure patients lacked ventriculoatrial conduction. Ten patients had symptomatic dizziness after VVI pacing; the incidence of symptoms was higher in patients with ventriculoatrial conduction (9 of 23) than in those without ventriculoatrial conduction (1 of 27) (P<0.003). We conclude that the presence of intact ventriculoatrial conduction appears to be a crucial determinent of the hemodynamic response to VVI pacing, and its presence may identify patients who are at risk for “pacemaker syndrome.”",
keywords = "atrioventricular synchrony, dual‐chamber pacing, pacemaker syndrome, permanent pacing, ventriculer demand pacing",
author = "Nishimura, {Rick A.} and Gersh, {Bernard J.} and Vlietstra, {Ronald E.} and Osborn, {Michael J.} and Ilstrup, {Duane M.} and David Holmes",
year = "1982",
month = "1",
day = "1",
doi = "10.1111/j.1540-8159.1982.tb00029.x",
language = "English (US)",
volume = "5",
pages = "903--910",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Hemodynamic and Symptomatic Consequences of Ventricular Pacing

AU - Nishimura, Rick A.

AU - Gersh, Bernard J.

AU - Vlietstra, Ronald E.

AU - Osborn, Michael J.

AU - Ilstrup, Duane M.

AU - Holmes, David

PY - 1982/1/1

Y1 - 1982/1/1

N2 - NISHIMURA, R.A. et al.: Hemodynamic and symptomatic consequences of ventricular pacing. After implantation of a ventricular demand pacemaker (VVI), occasional patients continue to have dizziness, syncope, or near syncope (“pacemaker syndrome”). To identify patients in whom VVI pacing may have deleterious effects, we compared cuff blood pressure responses to VVI pacing with blood pressure responses to atrioventricsler sequential pacing (DVI) or sinus rhythm in 50 consecutive patients. Patients with intact ventriculoatrial conduction had a much greater decrease in systolic blood pressure with VVI pacing (24 ± 11 mm Hg) than those with ventriculoatrial dissociation (−4 ± 15 mm Hg) (P<0.005). Patients who were in heart failure had a lesser decrease in blood pressure with VVI pacing than did those without failure (P<0.05); 13 of the 14 heart failure patients lacked ventriculoatrial conduction. Ten patients had symptomatic dizziness after VVI pacing; the incidence of symptoms was higher in patients with ventriculoatrial conduction (9 of 23) than in those without ventriculoatrial conduction (1 of 27) (P<0.003). We conclude that the presence of intact ventriculoatrial conduction appears to be a crucial determinent of the hemodynamic response to VVI pacing, and its presence may identify patients who are at risk for “pacemaker syndrome.”

AB - NISHIMURA, R.A. et al.: Hemodynamic and symptomatic consequences of ventricular pacing. After implantation of a ventricular demand pacemaker (VVI), occasional patients continue to have dizziness, syncope, or near syncope (“pacemaker syndrome”). To identify patients in whom VVI pacing may have deleterious effects, we compared cuff blood pressure responses to VVI pacing with blood pressure responses to atrioventricsler sequential pacing (DVI) or sinus rhythm in 50 consecutive patients. Patients with intact ventriculoatrial conduction had a much greater decrease in systolic blood pressure with VVI pacing (24 ± 11 mm Hg) than those with ventriculoatrial dissociation (−4 ± 15 mm Hg) (P<0.005). Patients who were in heart failure had a lesser decrease in blood pressure with VVI pacing than did those without failure (P<0.05); 13 of the 14 heart failure patients lacked ventriculoatrial conduction. Ten patients had symptomatic dizziness after VVI pacing; the incidence of symptoms was higher in patients with ventriculoatrial conduction (9 of 23) than in those without ventriculoatrial conduction (1 of 27) (P<0.003). We conclude that the presence of intact ventriculoatrial conduction appears to be a crucial determinent of the hemodynamic response to VVI pacing, and its presence may identify patients who are at risk for “pacemaker syndrome.”

KW - atrioventricular synchrony

KW - dual‐chamber pacing

KW - pacemaker syndrome

KW - permanent pacing

KW - ventriculer demand pacing

UR - http://www.scopus.com/inward/record.url?scp=0020442437&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0020442437&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8159.1982.tb00029.x

DO - 10.1111/j.1540-8159.1982.tb00029.x

M3 - Article

C2 - 6184693

AN - SCOPUS:0020442437

VL - 5

SP - 903

EP - 910

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 6

ER -