Hemodynamics of Cardiac Pacing: Optimization and Programming to Enhance Cardiac Function

Hemodynamic consequences of cardiac pacing have evolved dramatically over the past several decadesIn practice, with the exception of cardiac resynchronization devices, echocardiographic optimization is rarely performedTaking the interatrial and intra-atrial delay into consideration and programming the differential atrioventricular (AV) interval accordingly may result in improved hemodynamicsAcute hemodynamic studies suggest that optimal ventricular contractility is further enhanced in individual patients when a patient's specific AV interval is programmedMany individuals with left ventricle dysfunction have a number of associated comorbidities, such as diabetes mellitus, renal failure, coronary artery disease, hypertension, and chronic obstructive pulmonary disease, amongst othersAn early study of the effect of pacing mode on morbidity and mortality paved the way for subsequent clinical trials to examine the effect of pacing mode on morbidity and mortality, as well as the potential adverse effects of VVI pacing.