Physiological pacing improves symptoms and increases exercise capacity in the elderly patient.
We evaluated the benefits of physiological pacing in the elderly by recruiting 13 subjects > 75 years of age, already fitted with a physiological pacing system. All had been paced for complete or Mobitz II heart block. Double blind cross over study was performed comparing exercise capacity, measuring distance walked on a 6-min walking test and time taken to climb two flights of stairs; and symptoms, evaluated by an activity of daily living questionnaire, in atrioventricular synchronous and ventricular pacing. Mean distance walked was significantly higher in atrioventricular synchronous than in ventricular pacing (360 +/- 65 m vs. 327 +/- 69 m; P < 0.01). No significant difference was found in the ability to climb stairs but there was a marked improvement in the symptomatic questionnaire score, 19 +/- 5 in physiological pacing increasing to 28 +/- 10 with ventricular. Physiological pacing in the elderly produces an increase in exercise tolerance and improves symptoms; therefore, age alone should not be a contraindication to a physiological system.
Avery
P
P
Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, UK.
Banning
A
A
Lawson
T
T
McGurk
L
L
Buchalter
M
M
D000203:Activities of Daily Living; D000222:Adaptation, Physiological; D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005080:Exercise Test; D005260:Female; D006327:Heart Block / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010807:Physical Endurance; D016896:Treatment Outcome; D016138:Walking