Sutton R, Perrins E J, Morley C, Chan S L
Eur Heart J. 1983 Nov;4(11):781-5. doi: 10.1093/oxfordjournals.eurheartj.a061398.
Fifty-three patients have received 'physiological' pacemakers, 37 with atrioventricular (AV) block having atrial synchronous units (VAT or VDD) implanted and the remaining 16 patients with both AV block and sick sinus syndrome having 'universal' (DDD) pacemakers. Effort tolerance was assessed by serial bicycle ergometry and in 16 patients direct comparisons between ventricular pacing and atrial synchronous pacing could be made acutely. Physiological pacemakers were found to increase maximum effort tolerance by 43% compared to pre-pacing values (P less than 0.01). The increase was sustained over a mean of 33 months post pacing. The atrial synchronous mode increased maximum effort tolerance by 34% acutely compared to ventricular inhibited pacing. Dual chambered 'physiological' pacemakers represent a significant therapeutic advance over standard ventricular inhibited pacemakers.
53例患者接受了“生理性”起搏器治疗，其中37例患有房室传导阻滞的患者植入了心房同步起搏器（VAT或VDD），其余16例患有房室传导阻滞和病态窦房结综合征的患者植入了“通用型”（DDD）起搏器。通过连续自行车测力计评估运动耐力，16例患者能够对心室起搏和心房同步起搏进行急性直接比较。结果发现，与起搏前值相比，生理性起搏器可使最大运动耐力提高43%（P<0.01）。这种提高在起搏后平均33个月内持续存在。与心室抑制起搏相比，心房同步模式可使最大运动耐力急性提高34%。双腔“生理性”起搏器相对于标准心室抑制起搏器代表了一项重大的治疗进展。
