Selection of an optimal atrioventricular delay improved resting and exercise hemodynamics in a patient with dual-chamber pacemaker and severe left ventricular systolic dysfunction

P. Vijayaraman, R. Bijou, Jay N. Gross, J. Shirani

Research output: Contribution to journalArticle

Abstract

In a patient with severe left ventricular (LV) systolic dysfunction and permanent dual-chamber pacemaker, Doppler cardiographic LV stroke volume was measured at rest and during exercise at 4 different atrioventricular (AV) delays (60, 80, 100, and 160 msec). Maximum stroke volume of 49 ml (cardiac output 4.1 L/min) was obtained at an AV delay of 80 msec at rest. Similarly, an AV delay of 80 msec resulted in maximum stroke volume of 54 ml during exercise (cardiac output 5.8 L/min). The increased stroke volume at rest and during exercise at an AV delay of 80 msec was primarily due to longer diastolic filling time, higher atrial filling fraction, and lower mitral regurgitant fraction. Thus, the beneficial effects of an optimal AV delay on resting hemodynamics in LV systolic failure appears to be sustained during exercise and may explain improved exercise tolerance in some patients with dual-chamber pacing.

Original languageEnglish (US)
Pages (from-to)261-264
Number of pages4
JournalHeart Failure
Volume11
Issue number6
StatePublished - 1995

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Left Ventricular Dysfunction
Stroke Volume
Hemodynamics
Exercise
Cardiac Output
Exercise Tolerance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "In a patient with severe left ventricular (LV) systolic dysfunction and permanent dual-chamber pacemaker, Doppler cardiographic LV stroke volume was measured at rest and during exercise at 4 different atrioventricular (AV) delays (60, 80, 100, and 160 msec). Maximum stroke volume of 49 ml (cardiac output 4.1 L/min) was obtained at an AV delay of 80 msec at rest. Similarly, an AV delay of 80 msec resulted in maximum stroke volume of 54 ml during exercise (cardiac output 5.8 L/min). The increased stroke volume at rest and during exercise at an AV delay of 80 msec was primarily due to longer diastolic filling time, higher atrial filling fraction, and lower mitral regurgitant fraction. Thus, the beneficial effects of an optimal AV delay on resting hemodynamics in LV systolic failure appears to be sustained during exercise and may explain improved exercise tolerance in some patients with dual-chamber pacing.",
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AU - Vijayaraman, P.

AU - Bijou, R.

AU - Gross, Jay N.

AU - Shirani, J.

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N2 - In a patient with severe left ventricular (LV) systolic dysfunction and permanent dual-chamber pacemaker, Doppler cardiographic LV stroke volume was measured at rest and during exercise at 4 different atrioventricular (AV) delays (60, 80, 100, and 160 msec). Maximum stroke volume of 49 ml (cardiac output 4.1 L/min) was obtained at an AV delay of 80 msec at rest. Similarly, an AV delay of 80 msec resulted in maximum stroke volume of 54 ml during exercise (cardiac output 5.8 L/min). The increased stroke volume at rest and during exercise at an AV delay of 80 msec was primarily due to longer diastolic filling time, higher atrial filling fraction, and lower mitral regurgitant fraction. Thus, the beneficial effects of an optimal AV delay on resting hemodynamics in LV systolic failure appears to be sustained during exercise and may explain improved exercise tolerance in some patients with dual-chamber pacing.

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