[Chronotropic competence in patients with the sick sinus syndrome wearing AAI or DDD pacemakers].
The prevalence of chronotropic incompetence in patients with sinus node disease (SND) is not well defined. To assess this, we evaluated 18 patients (7 men, 11 women; mean age: 64 +/- 11) with SND and permanent pacemakers (AAI/DDD) with Holter monitoring and treadmill stress test. Only 2 patients received active cardiac drugs (1, L-dopa an 1 propafenone). The treadmill tests results were compared with a control group of 15 men and 18 women (mean age: 66 +/- 5, p = NS) without organic heart disease. During ambulatory activity all pacemaker patients increased their own cardiac rate to a value higher than the programmed basic pacemaker rate. In 8 patients the maximal rate attained was over 100/min (mean 95 +/- 19/min). The maximal rate during treadmill test in pacemaker patients was 131 +/- 25 (control group 138 +/- 14, p = NS). Exercise tolerance in METs was similar in pacemaker patients (5.2 +/- 2.6) and in controls (5.8 +/- 1.2) (p = NS). Two pacemaker patients (12%) didn't reach 100/min during stress test. Most patients with SND and permanent pacemakers (AAI/DDD) are able to increase cardiac rate during exercise. Rate responsive pacing (AAIR/DDDR) should be limited to a minority of patients with true chronotropic incompetence.
Goicolea de Oro
A
A
Servicio de Cardiología, Hospital Universitario de Getafe, Madrid.
Márquez
L
L
López Gil
M
M
Kallmeyer
C
C
Chicote
R
R
García-Cosío
F
F
D000368:Aged; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data; D004867:Equipment Design; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data; D005082:Physical Exertion; D012804:Sick Sinus Syndrome / Q000503:physiopathology* / Q000628:therapy
Capacidad de taquicardización en pacientes con enfermedad del nódulo sinusal portadores de marcapasos AAI o DDD.