[Doppler echocardiography of the effect of atrioventricular delay on transmitral flow in dual chamber pacing. Role of associated cardiopathy].
Doppler echocardiography was used to analyse transmitral blood flow in 23 patients undergoing DDD pacing under basal conditions at a pacing rate of 70/min. Changes in the atrioventricular delay led to changes in Doppler parameters corresponding to the different phases of ventricular filing. When the atrioventricular interval was increased, the maximum velocity, the velocity time integral and the duration of the E wave decreased and the maximum velocity, the velocity time integral and duration of the A wave increased. The atrial contribution to left ventricular filing increased by 15 to 46% (p less than 0.001). The changes of the Doppler parameters with respect to the duration of the atrioventricular interval varied according to the patient group studied. Patients without ventricular dilatation with or without hypertrophy had greater maximum velocities and velocity time integrals of the A wave than patients with left ventricular dilatation. However, for the same changes in atrioventricular delay, the A wave and atrial contribution to left ventricular filing were more variable in patients without left ventricular dilatation than those with left ventricular dilatation confirming the greater sensitivity of patients without left ventricular dilatation to the setting of the atrioventricular interval. These results confirm the great variability of transmitral flow with changes in atrioventricular delay. They illustrate the need for appropriate programming of the atrioventricular delay especially in patients in whom the mitral flow is most sensitive to this adjustment.
Lascault
G
G
Service de rythmologie et de stimulation cardiaque, hôpital Jean Rostand, Ivry.
Abergel
E
E
Frank
R
R
Petitot
J C
JC
Fontaine
G
G
Grosgogeat
Y
Y
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D013318:Stroke Volume; D016277:Ventricular Function, Left
Etude par échocardiographie doppler de l'influence du délai auriculoventriculaire sur le flux transmitral en stimulation double chambre. Rôle de la cardiopathie sous-jacente.