Atrial pacing lead location alters the effects of atrioventricular delay on atrial and ventricular hemodynamics. Pacing Clin Electrophysiol 2002 Jun;25(6):888-96
Date
07/26/2002Pubmed ID
12137340DOI
10.1046/j.1460-9592.2002.00888.xScopus ID
2-s2.0-0036310875 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
The combined role of atrial pacing lead location and AV timing on cardiovascular performance has not been defined. This study tested the hypothesis that atrial pacing lead location can change the dependence of LA and LV hemodynamics on AV timing in vivo. Dogs anesthetized with isoflurane (n = 8) were instrumented for measurement of hemodynamics including LA pressure, LA volume, and pulmonary venous bloodflow. Data were recorded during normal sinus rhythm, and atrial overdrive pacing from the right atrial appendage (RAA), proximal coronary sinus (CS), and LA lateral wall (LAW). The AV node was then ablated and measurements repeated during synchronous ventricular pacing and during dual chamber pacing from each atrial lead location at various AV delays (20, 60, 120, 180, 240, and 350 ms). Hemodynamics during intrinsic sinus rhythm and overdrive atrial pacing from different sites were similar. In contrast, ventricular or dual chamber pacing caused significant (P < 0.05) changes in cardiac output with different AV timing during RAA (3.5 +/- 0.2 vs 2.9 +/- 0.2 L/min at 120 and 350 ms, respectively) and LAW pacing but not CS pacing. A significant interaction between atrial lead location and AV delay was observed for changes in stroke volume, pulmonary venous blood transport, LA volume, and LV preload. The results indicate that the atrial contribution to cardiac output depends on AV timing and atrial lead location in isoflurane-anesthetized dogs with AV nodal conduction block.
Author List
Hettrick DA, Euler DE, Pagel PS, Musley SK, Warman EN, Ziegler PD, Mehra RAuthor
Paul S. Pagel MD, PhD Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnimalsAtrial Function, Left
Atrioventricular Node
Cardiac Pacing, Artificial
Dogs
Electrocardiography
Heart Rate
Hemodynamics
Ventricular Function, Left