Mitrović V, Neuss H, Buss J, Thormann J, Schlepper M
Z Kardiol. 1982 Dec;71(12):824-9.
The effects of several modes of stimulation (right ventricular pacing during sinus rhythm, right ventricular pacing during induced atrial fibrillation, and atrioventricular (AV) sequential pacing with an AV delay of 130 msec) on blood pressure and cardiac output were investigated in 10 patients with normal left ventricular function. The stimulation rates were 110, 140, and 170/min for each stimulation mode. There were no significant differences between ventricular pacing in sinus rhythm and ventricular pacing in atrial fibrillation as regards blood pressure and cardiac output. Ventricular stimulation during atrial fibrillation resulted in a significant fall in systolic blood pressure (84%, p less than 0.05) even at a rate of 140/min, whereas in AV-sequential pacing systolic blood pressure only fell to 87% of the baseline value at a rate of 170/min. A significant decrease in cardiac output occurred at rates of 140/min ventricular pacing during atrial fibrillation and at rates of 170/min with AV-sequential pacing. The results underline the importance of active ventricular filling in tachycardia. There were no significant differences in the measured parameters when ventricular pacing with AV-dissociation was compared with ventricular pacing at identical rates during atrial fibrillation.
在10例左心室功能正常的患者中,研究了几种刺激模式(窦性心律时右心室起搏、诱发房颤时右心室起搏以及房室延迟为130毫秒的房室顺序起搏)对血压和心输出量的影响。每种刺激模式的刺激频率分别为110、140和170次/分钟。窦性心律时的心室起搏与房颤时的心室起搏在血压和心输出量方面无显著差异。即使在频率为140次/分钟时,房颤期间的心室刺激也会导致收缩压显著下降(84%,p<0.05),而在房室顺序起搏中,仅在频率为170次/分钟时收缩压才降至基线值的87%。房颤期间心室起搏频率为140次/分钟以及房室顺序起搏频率为170次/分钟时,心输出量出现显著下降。结果强调了心动过速时心室主动充盈的重要性。将房室分离时的心室起搏与房颤期间相同频率的心室起搏相比,测量参数无显著差异。