Acute effects of VVI pacing on ventricular diastolic performance in elderly patients with normal left ventricular systolic function.

Elderly patients may have left ventricular (LV) diastolic dysfunction, which is associated with worse outcome. To assess LV diastolic function we sought relationships between echocardiographic tissue Doppler imaging (TDI) and color M-Mode (CMM) techniques and B-type natriuretic peptide (BNP) responses following short-term VVI pacing in dual-chamber pacemaker recipients with normal LV ejection fraction. In 58 clinically stable elderly patients baseline TDI and CMM data, and BNP [median (IQR)] levels during atrioventricular rhythm were obtained and compared with echocardiographic data during VVI pacing and BNP responses following a 30-min VVI pacing period. Overall, VVI pacing worsened LV diastolic function and increased the E/Ea mean (P<0.05). Baseline BNP levels [58 (23-138) pg/ml] increased approximately 26% following VVI pacing. Short-term VVI pacing in elderly patients may deteriorate LV function and provoke BNP increases.