French W J, Haskell R J, Wesley G W, Florio J
Department of Medicine, UCLA School of Medicine.
Pacing Clin Electrophysiol. 1988 Nov;11(11 Pt 2):1840-5. doi: 10.1111/j.1540-8159.1988.tb06318.x.
Dual chamber rate responsive pacing may be an ideal mode but may result in high current drain and premature battery depletion. To minimize battery drain during exercise, this study compared a combination pacing mode of DDD and ventricular rate responsive pacing (VVIR). Nine patients were studied who had complete heart block, sinus rhythm, DDD pacemakers, and a reduced mean left ventricular ejection fraction of 44%. Patients were exercised in DDD, VVIR, and a combination of DDD at low heart rates and VVIR at mean heart rates over 89 bpm. Blood pressure, heart rate, exercise duration, work rate, oxygen uptake, anaerobic threshold, and oxygen pulse were measured. There was no difference in symptoms or in mean cardiopulmonary function indices including exercise duration 10.7, 10.3, 10.3 minutes; heart rate 127, 133, 136 bpm; oxygen uptake 1.4, 1.5, 1.5 L/minute; or anaerobic threshold 5.6, 5.5, 5.7 minutes (p greater than 0.05) in any mode. A pacemaker that provides atrioventricular synchrony at low heart rates with ventricular rate responsiveness at high heart rates may be an alternative mode for some patients.
双腔频率应答式起搏可能是一种理想模式，但可能导致高电流消耗和电池过早耗尽。为了在运动期间将电池消耗降至最低，本研究比较了DDD和心室频率应答式起搏（VVIR）的联合起搏模式。对9例患有完全性心脏传导阻滞、窦性心律、植入DDD起搏器且平均左心室射血分数降低至44%的患者进行了研究。患者分别以DDD模式、VVIR模式以及低心率时采用DDD模式和平均心率超过89次/分时采用VVIR模式的联合方式进行运动。测量了血压、心率、运动持续时间、工作率、摄氧量、无氧阈值和氧脉搏。在任何模式下，症状或平均心肺功能指标（包括运动持续时间分别为10.7、10.3、10.3分钟；心率分别为127、133、136次/分；摄氧量分别为1.4、1.5、1.5升/分钟；或无氧阈值分别为5.6、5.5、5.7分钟）均无差异（p大于0.05）。对于某些患者而言，一种在低心率时提供房室同步且在高心率时具有心室频率应答性的起搏器可能是一种替代模式。
