Hoeschen R J, Reimold S C, Lee R T, Plappert T J, Lamas G A
University of Manitoba, St. Boniface General Hospital, Winnipeg, Canada.
Pacing Clin Electrophysiol. 1991 May;14(5 Pt 1):756-9. doi: 10.1111/j.1540-8159.1991.tb04101.x.
In order to determine whether the hemodynamic benefit of atrioventricular synchronous pacing is maintained in the upright position, 14 patients with dual chamber pacemakers were paced in VVI mode and DDD mode in both the supine and standing position. The hemodynamic response was assessed by measuring the velocity time integral derived from the pulsed-wave Doppler signal in the left ventricular outflow tract during VVI pacing and dual chamber pacing at three different AV delays (125, 200, 250 ms). In the supine position, the velocity time integral during VVI pacing was 14.6 +/- 3.0 cm and this increased during DDD pacing at all three AV delays (17.7 +/- 3.3, 17.9 +/- 3.0, 17.5 +/- 3.5 cm). In the upright position, the velocity time integral during VVI pacing was 12.9 +/- 3.5 cm and this increased with DDD pacing (15.5 +/- 3.3, 15.1 +/- 4.0, 15.1 +/- 3.9 cm). It was concluded that although stroke volume decreases when assuming the upright position, the beneficial response to dual chamber pacing is maintained and equals that observed in the supine position.
为了确定房室同步起搏的血流动力学益处是否在直立位时得以维持，对14例双腔起搏器患者在仰卧位和站立位时分别以VVI模式和DDD模式进行起搏。通过测量在VVI起搏和双腔起搏时三个不同房室延迟（125、200、250毫秒）下左心室流出道脉冲波多普勒信号得出的速度时间积分来评估血流动力学反应。在仰卧位时，VVI起搏时的速度时间积分为14.6±3.0厘米，在所有三个房室延迟的DDD起搏期间均增加（17.7±3.3、17.9±3.0、17.5±3.5厘米）。在直立位时，VVI起搏时的速度时间积分为12.9±3.5厘米，且在DDD起搏时增加（15.5±3.3、15.1±4.0、15.1±3.9厘米）。得出的结论是，尽管在采取直立位时每搏输出量会降低，但对双腔起搏的有益反应得以维持，且与仰卧位时观察到的反应相当。
