Jones R I, Cashman P M, Hornung R S, Prince H, Bassein L, Raftery E B
Br Heart J. 1986 May;55(5):462-8. doi: 10.1136/hrt.55.5.462.
Ten patients in sinus rhythm with ventricular demand (VVI) pacemakers implanted for the sick sinus syndrome underwent 24 hour ambulatory blood pressure and electrocardiographic recording by a modified version of the Oxford system. Five patients had symptoms of dizziness or presyncope at the time of study and five were symptom free. The onset of pacing was associated with a fall in arterial blood pressure in both groups which was larger in the patients with symptoms, and in these patients the blood pressure recovery consequent on baroreflex activation was delayed by up to fifteen beats. In three of the patients with symptoms the original pacemaker was replaced by an atrioventricular pacing (DVI) device. This abolished symptoms and the initial fall and delayed recovery of blood pressure. Thus it appears that the development of symptoms of hypotension after the onset of ventricular pacing is determined by the rate of the baroreflex response. These symptoms and the haemodynamic consequences may be alleviated by dual chamber pacing.
十名因病态窦房结综合征植入心室按需（VVI）起搏器且处于窦性心律的患者，通过牛津系统的改良版本进行了24小时动态血压和心电图记录。研究时，五名患者有头晕或接近晕厥的症状，五名患者无症状。两组患者起搏开始时均伴有动脉血压下降，有症状的患者下降幅度更大，且在这些患者中，压力反射激活后血压恢复延迟多达15次心跳。三名有症状的患者将原来的起搏器更换为房室起搏（DVI）装置。这消除了症状以及血压的初始下降和延迟恢复。因此，似乎心室起搏开始后低血压症状的出现取决于压力反射反应的速率。双腔起搏可缓解这些症状和血流动力学后果。
